CMS Price Transparency Data
Sleep study (overnight, in lab)
Facility: Mercy Hospital Carthage
Billing Code: 95810 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 95810
- Insurance Median: $2,973
- Cash Discount Price: $2,811
- vs. Medicare Baseline: 3.39x Medicare
The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Mercy Hospital Carthage is $2,973. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,811. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 3.39x the Medicare baseline. Located in 3125 Dr Russell Smith Way, Carthage, MO.
Cash / Self-Pay
$2,811
Average discount available for prompt cash payment at this facility.
Insurance Median
$2,973
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: $2,811 (320%)
Insurance Median: $2,973 (339%)
Cash: $2,811 (320% of Medicare)
Ins. Median: $2,973 (339% 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 339% of the Medicare baseline (a markup of 239%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $383 - $3,341 | 44% |
| Medicaid / KanCare | $383 - $2,670 | 44% |
| Aetna | $528 - $4,329 | 60% |
| Humana | $528 - $1,459 | 60% |
| Medicare (plans) | $952 - $1,439 | 109% |
| Cherokee Nation Health Serv Contracted [320066] | $1,040 - $1,336 | 119% |
| Cigna | $1,040 - $4,378 | 119% |
| Cross Timbers Hospice [20098] | $1,040 - $1,336 | 119% |
| Dept Of Veteran Affairs Contracted [320106] | $1,040 - $1,336 | 119% |
| Elara Caring Aspire Hospice [20433] | $1,040 - $1,336 | 119% |
| Globalhealth Contracted [320145] | $1,040 - $1,336 | 119% |
| Halo Hcr Inc Hospice Contracted [320432] | $1,040 - $1,336 | 119% |
| Halo Hcr Inc Hospice [20432] | $1,040 - $1,336 | 119% |
| Indian Health Service Contracted [320198] | $1,040 - $1,336 | 119% |
| Kindful Hospice Contracted [320434] | $1,040 - $1,336 | 119% |
| Kindful Hospice [20434] | $1,040 - $1,336 | 119% |
| Medical Associates Health Contracted [320444] | $1,040 - $1,336 | 119% |
| Mercy Hospice Okc [20252] | $1,040 - $1,336 | 119% |
| Mercy Mgd Behavioral Health Contracted [320259] | $1,040 - $1,336 | 119% |
| Pace Of The Ozarks Contracted [320518] | $1,040 - $1,336 | 119% |
| Provider Partners Health Plans Contracted [320450] | $1,040 - $1,336 | 119% |
| Qual Choice Contracted [320325] | $1,040 - $1,336 | 119% |
| UnitedHealthcare | $1,040 - $4,232 | 119% |
| Tricare | $1,044 - $1,341 | 119% |
| Point C Contracted [320238] | $1,325 - $4,378 | 151% |
| Health Systems Inc Contracted [320174] | $1,628 - $2,092 | 186% |
| Insurance System Inc Contracted [320465] | $1,628 - $2,092 | 186% |
| Administrative Payor Contracted [320005] | $1,703 - $2,189 | 194% |
| Centivo Contracted [320505] | $1,741 - $2,237 | 198% |
| Healthscope Contracted [320182] | $1,972 - $2,534 | 225% |
| Ambetter / Centene | $2,078 - $2,670 | 237% |
| Home State Health Plan Contracted [320187] | $2,078 - $2,670 | 237% |
| Novasys Contracted [320285] | $2,078 - $2,670 | 237% |
| Benefit Management Contracted [320052] | $2,271 - $4,232 | 259% |
| Auxiant Contracted [320462] | $2,460 - $4,134 | 280% |
| Healthlink Contracted [320179] | $2,460 - $4,524 | 280% |
| Preferred Health Plan Contracted [320522] | $2,460 - $3,162 | 280% |
| Workers Comp [20426] | $3,028 - $4,864 | 345% |
| United Medical Resources Contracted [320454] | $3,142 - $4,378 | 358% |
| 90 Degree Benefits Contracted [320436] | $3,217 - $4,134 | 367% |
| Aither Health Contracted [320449] | $3,217 - $4,134 | 367% |
| Ebms Contracted [320493] | $3,217 - $4,134 | 367% |
| Edison Health Solutions Contracted [320502] | $3,217 - $4,134 | 367% |
| Imagine 360 Contracted [320494] | $3,217 - $4,134 | 367% |
| Mercy Benefit Admin Contracted [320251] | $3,217 - $4,378 | 367% |
| Reflect Health Contracted [320492] | $3,217 - $4,134 | 367% |
| Show-Me Health Administrators Contracted [320483] | $3,217 - $4,134 | 367% |
| Yuzu Health Contracted [320521] | $3,217 - $4,134 | 367% |
| Medica Contracted [320239] | $3,278 - $4,212 | 374% |
| Evolutions Health Care Contracted [320124] | $3,293 - $4,232 | 375% |
| First Health Contracted [320128] | $3,293 - $4,232 | 375% |
| Multiplan Contracted [320270] | $3,293 - $4,232 | 375% |
| Private Health Care Systems Contracted [320320] | $3,293 - $4,232 | 375% |
| American Healthcare Alliance Contracted [320020] | $3,406 - $4,378 | 388% |
| Ppo Plus Contracted [320310] | $3,406 - $4,378 | 388% |
| Usa Managed Care Org Contracted [320429] | $3,406 - $4,378 | 388% |