Sleep study (overnight, in lab)
Facility: Golden Valley Memorial Hospital
Billing Code: 95810 (CPT)
- CPT Billing Code: 95810
- Insurance Median: $936
- Cash Discount Price: $1,594
- vs. Medicare Baseline: 1.07x 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 |
|---|---|---|
| Aetna | $511 - $1,022 | 58% |
| Humana | $511 - $1,022 | 58% |
| UnitedHealthcare | $511 - $1,737 | 58% |
| Ambetter / Centene | $613 - $1,226 | 70% |
| Home State Health | $936 | 107% |
Consumer Guidance & Cost Commentary
For a sleep study (overnight, in lab) at Golden Valley Memorial Hospital in Clinton, MO, the cash median price is $1,594, which is significantly higher than the facility's negotiated rate of $936. This facility, owned by the Government - Hospital District or Authority, has a facility rating of 3 and serves acute care patients. While the cash price is the highest figure presented, it is important to note that commercial insurance carriers like UnitedHealthcare and UnitedHealthcare/Ambetter pay negotiated rates ranging from $511 to $1,737, meaning the cash rate is not the lowest possible option for insured patients.
The Medicare amount for this service is $877.34, which serves as a benchmark for the true cost of care. When comparing the cash price of $1,594 to the Medicare rate of $877.34, the commercial cash rate is approximately 1.1 times the Medicare amount. Patients should be aware that while cash-pay options can sometimes be cheaper for those with high-deductible plans if the insurance negotiated rate exceeds the cash price, the data shows the negotiated rate of $936 is lower than the cash price. To secure the best financial outcome, patients are encouraged to check with the hospital directly for "self-pay" or "prompt-pay" discounts, as these upfront payment incentives can reduce the final bill. Additionally, since over 80% of hospital bills contain errors, patients should request a full itemized CPT-coded bill to review for code unbundling or services not rendered before agreeing to any payment plan.