CMS Price Transparency Data
Sleep study (overnight, in lab)
Facility: Mercy Hospital St Louis
Billing Code: 95810 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 95810
- Insurance Median: $2,364
- Cash Discount Price: $3,573
- vs. Medicare Baseline: 2.69x Medicare
The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Mercy Hospital St Louis is $2,364. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,573. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 2.69x the Medicare baseline. Located in 615 New Ballas Road, Saint Louis, MO.
Cash / Self-Pay
$3,573
Average discount available for prompt cash payment at this facility.
Insurance Median
$2,364
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: $3,573 (407%)
Insurance Median: $2,364 (269%)
Cash: $3,573 (407% of Medicare)
Ins. Median: $2,364 (269% 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 269% of the Medicare baseline (a markup of 169%). 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 |
|---|---|---|
| Aetna | $287 - $2,045 | 33% |
| Medicaid / KanCare | $287 - $1,578 | 33% |
| American Health Advantage Of Mo Mcr [10473] | $945 | 108% |
| Blue Cross Blue Shield | $945 - $5,260 | 108% |
| Cherokee Nation Health Serv Contracted [320066] | $945 | 108% |
| Cross Timbers Hospice [20098] | $945 | 108% |
| Dept Of Veteran Affairs Contracted [320106] | $945 | 108% |
| Elara Caring Aspire Hospice Contracted [320433] | $945 | 108% |
| Elara Caring Aspire Hospice [20433] | $945 | 108% |
| Globalhealth Contracted [320145] | $945 | 108% |
| Halo Hcr Inc Hospice Contracted [320432] | $945 | 108% |
| Halo Hcr Inc Hospice [20432] | $945 | 108% |
| Humana | $945 | 108% |
| Kindful Hospice Contracted [320434] | $945 | 108% |
| Kindful Hospice [20434] | $945 | 108% |
| Medicare (plans) | $945 - $5,844 | 108% |
| Mercy Hospice Okc [20252] | $945 | 108% |
| Pace Of The Ozarks Contracted [320518] | $945 | 108% |
| Qual Choice Contracted [320325] | $945 | 108% |
| Tricare | $945 | 108% |
| UnitedHealthcare | $945 - $2,043 | 108% |
| Cigna | $964 - $2,630 | 110% |
| Hope Trust Contracted [320488] | $964 | 110% |
| Provider Partners Health Plans Contracted [320450] | $1,042 | 119% |
| Medica Contracted [320239] | $1,154 - $1,525 | 132% |
| Ambetter / Centene | $1,193 - $1,578 | 136% |
| Home State Health Plan Contracted [320187] | $1,193 - $1,578 | 136% |
| Novasys Contracted [320285] | $1,193 - $1,578 | 136% |
| Healthscope Contracted [320182] | $1,205 | 137% |
| Centivo Contracted [320505] | $1,590 | 181% |
| Preferred Health Plan Contracted [320522] | $1,686 | 192% |
| Aither Health Contracted [320449] | $1,901 - $2,513 | 217% |
| Aither Health [20449] | $1,901 - $2,513 | 217% |
| Auxiant Contracted [320462] | $1,901 - $2,513 | 217% |
| Ebms Contracted [320493] | $1,901 - $2,513 | 217% |
| Edison Health Solutions Contracted [320502] | $1,901 - $2,513 | 217% |
| Healthlink Contracted [320179] | $1,901 - $3,974 | 217% |
| Imagine 360 Contracted [320494] | $1,901 - $2,513 | 217% |
| Mercy Benefit Admin Contracted [320251] | $1,901 - $2,630 | 217% |
| Mercy Benefit Admin [20251] | $1,901 - $2,630 | 217% |
| Reflect Health Contracted [320492] | $1,901 - $2,513 | 217% |
| Show-Me Health Administrators Contracted [320483] | $1,901 - $2,513 | 217% |
| Yuzu Health Contracted [320521] | $1,901 - $2,513 | 217% |
| United Medical Resources Contracted [320454] | $2,043 | 233% |
| Health Choices Contracted [320448] | $2,652 - $3,506 | 302% |
| Health Choices [20448] | $2,652 - $3,506 | 302% |
| Medical Associates Health Contracted [320444] | $2,652 - $3,506 | 302% |
| Federal Medical Center Contracted [320127] | $2,873 - $3,799 | 327% |
| Insurance System Inc Contracted [320465] | $2,873 - $3,799 | 327% |
| Point C Contracted [320238] | $2,873 - $3,799 | 327% |
| Tri State Healthcare Coalition Contracted [320379] | $2,873 - $3,799 | 327% |
| First Health Contracted [320128] | $3,094 - $4,149 | 353% |
| Mercy Mgd Behavioral Health Contracted [320259] | $3,094 - $4,091 | 353% |
| Multiplan Contracted [320270] | $3,094 - $4,383 | 353% |
| Private Health Care Systems Contracted [320320] | $3,094 - $4,091 | 353% |
| Workers Comp [20426] | $3,315 - $4,675 | 378% |