CMS Price Transparency Data
Sleep study (overnight, in lab)
Facility: Mercy Hospital Joplin
Billing Code: 95810 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 95810
- Insurance Median: $2,464
- Cash Discount Price: $3,725
- vs. Medicare Baseline: 2.81x Medicare
The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Mercy Hospital Joplin is $2,464. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,725. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 2.81x the Medicare baseline. Located in 100 Mercy Way, Joplin, MO.
Cash / Self-Pay
$3,725
Average discount available for prompt cash payment at this facility.
Insurance Median
$2,464
Median negotiated contract rate across all mapped commercial carriers.
Medicare Reference Rate
$877.34
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Medicare Reference Baseline: $877.34 (100%)
Cash / Self-Pay: $3,725 (425%)
Insurance Median: $2,464 (281%)
Cash: $3,725 (425% of Medicare)
Ins. Median: $2,464 (281% of 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 281% of the Medicare baseline (a markup of 181%). 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.
Input your details and click calculate to compare out-of-pocket costs.
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 | $122 - $1,605 | 14% |
| Blue Cross Blue Shield | $383 - $4,178 | 44% |
| Indian Health Service Contracted [320198] | $419 - $3,725 | 48% |
| Aetna | $528 - $3,553 | 60% |
| Humana | $528 - $1,719 | 60% |
| Champva [20065] | $906 | 103% |
| Cherokee Nation Health Serv Contracted [320066] | $906 | 103% |
| Cigna | $906 - $4,413 | 103% |
| Cross Timbers Hospice [20098] | $906 | 103% |
| Dept Of Veteran Affairs Contracted [320106] | $906 | 103% |
| Elara Caring Aspire Hospice [20433] | $906 | 103% |
| Globalhealth Contracted [320145] | $906 | 103% |
| Halo Hcr Inc Hospice Contracted [320432] | $906 | 103% |
| Halo Hcr Inc Hospice [20432] | $906 | 103% |
| Kindful Hospice Contracted [320434] | $906 | 103% |
| Kindful Hospice [20434] | $906 | 103% |
| Medicare (plans) | $906 - $952 | 103% |
| Mercy Hospice Okc [20252] | $906 | 103% |
| Mercy Mgd Behavioral Health Contracted [320259] | $906 | 103% |
| Pace Of The Ozarks Contracted [320518] | $906 | 103% |
| Provider Partners Health Plans Contracted [320450] | $906 | 103% |
| Qual Choice Contracted [320325] | $906 | 103% |
| Tricare | $906 | 103% |
| UnitedHealthcare | $906 - $2,350 | 103% |
| Centivo Contracted [320505] | $924 | 105% |
| Healthscope Contracted [320182] | $1,155 | 132% |
| Ambetter / Centene | $1,605 | 183% |
| Home State Health Plan Contracted [320187] | $1,605 | 183% |
| Novasys Contracted [320285] | $1,605 | 183% |
| Health Choice Contracted [320166] | $1,780 | 203% |
| Providrs Care Network Contracted [320484] | $1,882 | 215% |
| Point C Contracted [320238] | $2,006 - $4,585 | 229% |
| Medica Contracted [320239] | $2,086 | 238% |
| United Medical Resources Contracted [320454] | $2,350 - $3,782 | 268% |
| Benefit Management Contracted [320052] | $2,464 | 281% |
| Health Systems Inc Contracted [320174] | $2,464 | 281% |
| Insurance System Inc Contracted [320465] | $2,464 | 281% |
| Administrative Payor Contracted [320005] | $2,579 | 294% |
| Mercy Benefit Admin Contracted [320251] | $2,866 - $3,439 | 327% |
| Aither Health Contracted [320449] | $3,267 | 372% |
| Auxiant Contracted [320462] | $3,267 - $3,725 | 372% |
| Ebms Contracted [320493] | $3,267 | 372% |
| Edison Health Solutions Contracted [320502] | $3,267 | 372% |
| Healthlink Contracted [320179] | $3,267 - $4,585 | 372% |
| Imagine 360 Contracted [320494] | $3,267 | 372% |
| Reflect Health Contracted [320492] | $3,267 | 372% |
| Yuzu Health Contracted [320521] | $3,267 | 372% |
| 90 Degree Benefits Contracted [320436] | $3,439 | 392% |
| Show-Me Health Administrators Contracted [320483] | $3,439 | 392% |
| Preferred Health Plan Contracted [320522] | $3,725 | 425% |
| First Health Contracted [320128] | $3,903 | 445% |
| American Healthcare Alliance Contracted [320020] | $4,012 | 457% |
| Multiplan Contracted [320270] | $4,413 | 503% |
| Private Health Care Systems Contracted [320320] | $4,413 | 503% |
| Usable Contracted [320409] | $4,413 | 503% |
| Point C [20238] | $4,585 | 523% |
| Workers Comp [20426] | $4,585 - $5,731 | 523% |
| Usa Managed Care Org Contracted [320429] | $5,043 | 575% |
| Ppo Plus Contracted [320310] | $5,158 | 588% |