CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Nkc Health

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $3,222
Cash Discount Price: $1,899
vs. Medicare Baseline: 3.67x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Nkc Health is $3,222. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,899. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 3.67x the Medicare baseline. Located in 2800 Clay Edwards Drive, North Kansas City, MO.

Cash / Self-Pay

$1,899

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,222

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: $1,899 (216%)

Insurance Median: $3,222 (367%)

Cash: $1,899 (216% of Medicare)

Ins. Median: $3,222 (367% 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 367% of the Medicare baseline (a markup of 267%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
UnitedHealthcare	$860 - $2,716	98%
Humana	$882	101%
Occunet Network	$886	101%
Ambetter / Centene	$893	102%
Blue Cross Blue Shield	$980 - $6,824	112%
Wellfit	$1,247 - $1,333	142%
Oscar	$1,559 - $3,303	178%
Centrus Health Direct	$1,680 - $4,182	191%
Cigna	$1,974 - $4,182	225%
Aetna	$2,133 - $7,278	243%
Centivo	$2,521 - $5,338	287%
Quiktrip	$2,521 - $5,338	287%
Multiplan	$2,941 - $7,118	335%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $1,899.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 95810.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Nkc Health is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 95810.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.