CMS Price Transparency Data
Sleep study (overnight, in lab)
Facility: Mercy Hospital Springfield
Billing Code: 95810 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 95810
- Insurance Median: $2,128
- Cash Discount Price: $3,094
- vs. Medicare Baseline: 2.43x Medicare
The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Mercy Hospital Springfield is $2,128. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,094. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 2.43x the Medicare baseline. Located in 2115 S. Fremont Ave, Springfield, MO.
Cash / Self-Pay
$3,094
Average discount available for prompt cash payment at this facility.
Insurance Median
$2,128
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: $3,094 (353%)
Insurance Median: $2,128 (243%)
Cash: $3,094 (353% of Medicare)
Ins. Median: $2,128 (243% 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 243% of the Medicare baseline (a markup of 143%). 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.
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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 - $2,601 | 14% |
| Blue Cross Blue Shield | $383 - $4,882 | 44% |
| Aetna | $528 - $1,976 | 60% |
| Humana | $528 - $4,345 | 60% |
| Centurion Of Missouri [20459] | $904 | 103% |
| Champva [20065] | $904 | 103% |
| Cherokee Nation Health Serv Contracted [320066] | $904 | 103% |
| Cigna | $904 - $4,920 | 103% |
| Cross Timbers Hospice [20098] | $904 | 103% |
| Dept Of Veteran Affairs Contracted [320106] | $904 | 103% |
| Elara Caring Aspire Hospice [20433] | $904 | 103% |
| Globalhealth Contracted [320145] | $904 | 103% |
| Halo Hcr Inc Hospice Contracted [320432] | $904 | 103% |
| Halo Hcr Inc Hospice [20432] | $904 | 103% |
| Indian Health Service Contracted [320198] | $904 | 103% |
| Indian Health Service [20198] | $904 | 103% |
| Kindful Hospice Contracted [320434] | $904 | 103% |
| Kindful Hospice [20434] | $904 | 103% |
| Medicare (plans) | $904 - $950 | 103% |
| Mercy Hospice Okc [20252] | $904 | 103% |
| Mercy Mgd Behavioral Health Contracted [320259] | $904 | 103% |
| Mercy Rehab Hospital Contracted [320260] | $904 | 103% |
| Pace Of The Ozarks Contracted [320518] | $904 | 103% |
| Qual Choice Contracted [320325] | $904 | 103% |
| Tricare | $904 | 103% |
| UnitedHealthcare | $904 - $4,920 | 103% |
| Provider Partners Health Plans Contracted [320450] | $996 | 114% |
| Healthscope Contracted [320182] | $1,152 | 131% |
| Medica Contracted [320239] | $1,236 - $2,524 | 141% |
| Medica [20239] | $1,236 - $2,524 | 141% |
| Benefit Management Contracted [320052] | $1,252 - $2,556 | 143% |
| Health Systems Inc Contracted [320174] | $1,252 - $2,556 | 143% |
| Insurance System Inc Contracted [320465] | $1,252 - $2,556 | 143% |
| Ambetter / Centene | $1,274 - $2,601 | 145% |
| Home State Health Plan Contracted [320187] | $1,274 - $2,601 | 145% |
| Novasys Contracted [320285] | $1,274 - $2,601 | 145% |
| Administrative Payor Contracted [320005] | $1,408 - $3,195 | 160% |
| Evolutions Health Care Contracted [320124] | $1,408 - $2,876 | 160% |
| Point C Contracted [320238] | $1,408 - $4,792 | 160% |
| Point C [20238] | $1,408 - $2,876 | 160% |
| Centivo Contracted [320505] | $1,520 | 173% |
| Medical Destinations Contracted [320242] | $1,565 - $3,195 | 178% |
| Mercy Benefit Admin Contracted [320251] | $1,565 - $3,834 | 178% |
| Workers Comp [20426] | $1,565 - $5,432 | 178% |
| United Medical Resources Contracted [320454] | $1,628 - $3,323 | 186% |
| First Health Contracted [320128] | $1,753 - $3,578 | 200% |
| Aither Health Contracted [320449] | $1,784 - $3,642 | 203% |
| Auxiant Contracted [320462] | $1,784 - $4,154 | 203% |
| Ebms Contracted [320493] | $1,784 - $3,642 | 203% |
| Edison Health Solutions Contracted [320502] | $1,784 - $3,642 | 203% |
| Healthlink Contracted [320179] | $1,784 - $5,112 | 203% |
| Imagine 360 Contracted [320494] | $1,784 - $3,642 | 203% |
| Reflect Health Contracted [320492] | $1,784 - $3,642 | 203% |
| Yuzu Health Contracted [320521] | $1,784 - $3,642 | 203% |
| 90 Degree Benefits Contracted [320436] | $1,878 - $3,834 | 214% |
| Federal Medical Center Contracted [320127] | $1,878 - $3,834 | 214% |
| Show-Me Health Administrators Contracted [320483] | $1,878 - $3,834 | 214% |
| Providrs Care Network Contracted [320484] | $1,882 | 215% |
| Multiplan Contracted [320270] | $2,410 - $4,920 | 275% |
| Private Health Care Systems Contracted [320320] | $2,410 - $4,920 | 275% |
| Compcare Of The Ozarks Contracted [320437] | $2,473 - $5,048 | 282% |
| American Healthcare Alliance Contracted [320020] | $2,504 - $5,112 | 285% |
| Qual Choice Contracted [320324] | $2,504 - $5,112 | 285% |
| Municipal Health Plan Contracted [320271] | $2,535 - $5,176 | 289% |
| Usa Managed Care Org Contracted [320429] | $2,754 - $5,623 | 314% |
| Ppo Plus Contracted [320310] | $2,817 - $5,751 | 321% |