Sleep study (overnight, in lab)
Facility: Children'S Mercy South
Billing Code: 95810 (CPT)
- CPT Billing Code: 95810
- Insurance Median: $502
- Cash Discount Price: $2,462
- vs. Medicare Baseline: 0.57x 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 | $98 - $6,588 | 11% |
| Healthy Blue | $104 - $2,596 | 12% |
| Medicaid / KanCare | $105 - $396 | 12% |
| Wppa Providrs Care | $139 - $6,373 | 16% |
| Healthlink | $148 - $8,628 | 17% |
| Health Midwest Comprehensive Care | $159 - $6,382 | 18% |
| American Healthcare Alliance | $165 - $8,333 | 19% |
| Wellfit/Centrus | $220 - $6,373 | 25% |
| Humana | $223 - $6,520 | 25% |
| Orscheln | $225 - $6,373 | 26% |
| Centivo | $226 - $6,373 | 26% |
| Nebraska Furniture Mart | $228 - $6,373 | 26% |
| Quiktrip | $235 - $6,382 | 27% |
| Blue Cross Blue Shield | $254 - $7,255 | 29% |
| Medica | $265 - $5,716 | 30% |
| Aetna | $300 - $6,667 | 34% |
| Multiplan | $310 - $7,451 | 35% |
| Mercy Health | $331 - $7,353 | 38% |
| Coxhealth Network | $336 - $7,255 | 38% |
| Cigna | $362 - $6,814 | 41% |
| Coventry Health Care Of Kansas | $379 - $7,255 | 43% |
| National Preferred Provider Network | $400 - $8,824 | 46% |
| Home State Health | $570 - $2,281 | 65% |
Consumer Guidance & Cost Commentary
For the sleep study (overnight, in lab) procedure at Children's Mercy South in Overland Park, KS, the facility's cash price of $2,462 is significantly lower than the gross chargemaster rate of $5,129. While the facility's negotiated rates with major payers like UnitedHealthcare and Healthy Blue range from $98 to $2,596, these amounts often exceed the cash price, meaning patients with high-deductible plans might save money by paying out-of-pocket or utilizing a prompt-pay discount. It is important to note that commercial negotiated rates frequently include administrative overhead and can be 200% to 300% of the Medicare benchmark rate of $877.34, which serves as a scientifically validated baseline for the true cost of care. Consumers should verify their specific plan's deductible status before scheduling, as paying the full negotiated rate without meeting the deductible can result in substantial out-of-pocket costs that far surpass the cash alternative.
Patients should be aware that balance billing is generally prohibited for emergency care and non-emergency services at in-network facilities under the No Surprises Act, though unexpected ancillary services from out-of-network providers can sometimes trigger surprise bills. If a patient receives a summary bill, they should request a full itemized audit to identify errors, unbundled codes, or services not rendered, as over 80% of hospital bills contain inaccuracies. Additionally, while the facility is a voluntary non-profit, patients should explicitly ask for self-pay or prompt-pay discounts prior to check-in to avoid automatic claims submission that may void cash savings. By comparing the facility's rates directly to the Medicare benchmark and demanding itemized statements,