Sleep study (overnight, in lab)
Facility: Smith County Memorial Hospital
Billing Code: 95810 (CPT)
- CPT Billing Code: 95810
- Insurance Median: $1,681
- Cash Discount Price: $1,622
- vs. Medicare Baseline: 1.92x 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 |
|---|---|---|
| Medicaid / KanCare | $114 - $2,402 | 13% |
| Multiplan-All Plans | $202 - $2,162 | 23% |
| Blue Cross Blue Shield | $1,046 | 119% |
| Wppa-All Plans | $2,258 | 257% |
| Health Partners Of Ks Ppo-All Plans | $2,282 | 260% |
| UnitedHealthcare | $2,282 | 260% |
| Midlands Choice-All Plans | $2,282 | 260% |
Consumer Guidance & Cost Commentary
For the CPT code 95810, representing an overnight sleep study at Smith County Memorial Hospital in Smith Center, Kansas, the cash price is $1,622.00. This cash rate is significantly lower than the facility's gross chargemaster of $1,622.00, which appears to be the listed price before any discounts. When compared to the state average, the cash price of $1,622.00 is notably lower than the state median paid amount of $2,162.00. For patients with high-deductible plans, paying the cash price of $1,622.00 upfront may be more cost-effective than using insurance, as the negotiated rates for in-network payers like Multiplan-All Plans and Blue Cross Blue Shield range from $1,046 to $2,282, often exceeding the cash amount. Patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront incentives can further reduce the final bill.
Insurance coverage varies widely depending on the specific plan and payer. Medicaid / KanCare offers the lowest range at $114 to $2,402 across six plans, while UnitedHealthcare and Health Partners Of Ks PPO-All Plans have a fixed allowed amount of $2,282. The facility's negotiated rate of $1,681.00 sits between the lowest and highest payer amounts, reflecting the complex dynamics of commercial contracts. It is important to note that while the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, patients should