Sleep study (overnight, in lab)
Facility: Bob Wilson Memorial Hospital
Billing Code: 95810 (CPT)
- CPT Billing Code: 95810
- Insurance Median: $1,098
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 1.25x 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 |
|---|---|---|
| Centura Employee Plan | $785 | 89% |
| Blue Cross Blue Shield | $1,410 | 161% |
Consumer Guidance & Cost Commentary
For the CPT code 95810, representing an overnight sleep study at Bob Wilson Memorial Hospital in Ulysses, Kansas, the facility's negotiated rates range from $785 to $1,410 depending on the payer. This facility, a voluntary non-profit Critical Access Hospital, has a median negotiated rate of $1,098. Compared to the Medicare benchmark of $877.34, the negotiated rates are 1.3 times higher, reflecting the standard markup for commercial insurance contracts. While the facility does not currently list a specific cash-pay or self-pay price in this dataset, patients with high-deductible plans should consider that paying cash directly could sometimes be more cost-effective if the insurance negotiated rate exceeds the cash price. It is essential to contact the hospital directly to confirm if "self-pay" or "prompt-pay" discounts are available before scheduling, as these upfront payment incentives can significantly reduce the final bill.
To ensure you are not overcharged, it is critical to request a full itemized billing audit rather than accepting a summary bill that obscures individual line items. Over 80% of hospital bills contain errors, such as unbundled codes or charges for services not rendered, and paying a summary invoice without verification can lead to unnecessary debt. If you receive a bill, demand a detailed 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 providers at in-network facilities, it is vital to verify your plan's network status and deductible requirements beforehand to avoid unexpected out-of-pocket expenses.