Sleep study (overnight, in lab)
Facility: Mitchell County Hospital Health Systems
Billing Code: 95810 (CPT)
- CPT Billing Code: 95810
- Insurance Median: $3,264
- Cash Discount Price: $1,731
- vs. Medicare Baseline: 3.72x 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 372% of the Medicare baseline (a markup of 272%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
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 | $114 - $3,627 | 13% |
| First Health-All Plans | $185 - $3,264 | 21% |
| Aetna | $185 - $3,264 | 21% |
| Triwest Well Mark All Plans | $186 - $3,083 | 21% |
| Blue Cross Blue Shield | $1,056 | 120% |
| Pref Hlth Care Sytms Comm - All Plans | $3,264 | 372% |
| Phc Leased Ntwrk Access - All Plans | $3,446 | 393% |
| Multiplan Ppo - All Plans | $3,446 | 393% |
| Auxiant-All Plans | $3,446 | 393% |
| Cigna | $3,591 | 409% |
| Health Partners Ks-All Plans | $3,591 | 409% |
Consumer Guidance & Cost Commentary
For the sleep study procedure (CPT 95810) at Mitchell County Hospital Health Systems in Beloit, KS, the facility's cash median rate of $1,731 is significantly lower than the commercial negotiated rates, which average $3,264 across 11 payers. This price difference highlights a common billing dynamic where commercial insurance contracts often result in higher out-of-pocket costs for patients than paying cash directly. While the facility's negotiated rates are notably higher than the Medicare benchmark of $877.34, patients with high-deductible plans may find the cash price more advantageous if their insurance allows them to pay the full negotiated amount. To maximize savings, it is recommended to explicitly request "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can reduce the total cost by 20% to 50% by bypassing administrative claim processing fees.
When reviewing your final invoice, ensure you are not accepting a summary bill that obscures individual charges, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. If you receive a bill, demand a full itemized statement showing specific CPT codes and unit costs to identify any discrepancies before negotiating. Additionally, be aware that while the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, unexpected charges can still occur from ancillary providers like emergency physicians or labs. Always verify your deductible status before proceeding, as paying the full negotiated rate without meeting your deductible threshold can lead to unexpectedly high costs, whereas paying the lower cash price upfront may result in immediate savings and avoid the administrative delays associated with insurance claims.