Sleep study (overnight, in lab)
Facility: Scott County Hospital
Billing Code: 95810 (CPT)
- CPT Billing Code: 95810
- Insurance Median: $1,327
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 1.51x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Understanding this gauge: We use the federal Medicare rate of $877.34 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| UnitedHealthcare | $847 - $2,101 | 97% |
| Humana | $929 | 106% |
| Blue Cross Blue Shield | $1,056 | 120% |
| Wppa | $1,200 - $1,327 | 137% |
| Aetna | $1,991 | 227% |
Consumer Guidance & Cost Commentary
For the CPT code 95810 (Sleep study), Scott County Hospital in Scott City, KS, has a gross charge of $2,212.00. While the facility's negotiated rates with payers like UnitedHealthcare and Wppa range from $847 to $1,327, the cash price is not available in this report. It is important to note that cash payments can sometimes be more affordable for patients with high-deductible plans if the insurance negotiated rate exceeds the cash price. Since the facility is a Critical Access Hospital in Kansas, you should contact the billing department directly to inquire about "self-pay" or "prompt-pay" discounts, which can significantly reduce the final amount owed.
When evaluating costs, it is crucial to compare rates against the Medicare benchmark rather than the hospital's inflated gross charges. The Medicare amount for this service is $877.34, which serves as the objective baseline for fair pricing. Although the report does not provide specific state or county average data for this procedure, the Medicare rate reveals that the facility's gross charge is 1.5 times the federal standard. To avoid unexpected balance billing, ensure you understand your plan's network status, as the No Surprises Act protects you from out-of-network balance billing for emergency care and non-emergency services at in-network facilities. Always request a full itemized bill before paying to verify that all charges are accurate and that no unbundled codes or services not rendered have been included.