CMS Price Transparency Data
Sleep study (overnight, in lab)
Facility: Mercy Hospital Ardmore, Inc
Billing Code: 95810 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 95810
- Insurance Median: $4,149
- Cash Discount Price: $5,137
- vs. Medicare Baseline: 4.73x Medicare
The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Mercy Hospital Ardmore, Inc is $4,149. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,137. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 4.73x the Medicare baseline. Located in 1011 14Th Ave Nw, Ardmore, OK.
Cash / Self-Pay
$5,137
Average discount available for prompt cash payment at this facility.
Insurance Median
$4,149
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: $5,137 (586%)
Insurance Median: $4,149 (473%)
Cash: $5,137 (586% of Medicare)
Ins. Median: $4,149 (473% 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 473% of the Medicare baseline (a markup of 373%). 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 |
|---|---|---|
| Aetna | $528 - $5,026 | 60% |
| Humana | $528 - $5,453 | 60% |
| Medicaid / KanCare | $528 - $1,399 | 60% |
| Globalhealth Contracted [320144] | $850 | 97% |
| Blue Cross Blue Shield | $1,017 | 116% |
| Cherokee Nation Health Serv Contracted [320066] | $1,017 | 116% |
| Cross Timbers Hospice [20098] | $1,017 | 116% |
| Dept Of Veteran Affairs Contracted [320106] | $1,017 | 116% |
| Elara Caring Aspire Hospice Contracted [320433] | $1,017 | 116% |
| Elara Caring Aspire Hospice [20433] | $1,017 | 116% |
| Halo Hcr Inc Hospice Contracted [320432] | $1,017 | 116% |
| Halo Hcr Inc Hospice [20432] | $1,017 | 116% |
| Independent Health [20197] | $1,017 | 116% |
| Indian Health Service Contracted [320198] | $1,017 | 116% |
| Kindful Hospice Contracted [320434] | $1,017 | 116% |
| Kindful Hospice [20434] | $1,017 | 116% |
| Medical Associates Health [20444] | $1,017 | 116% |
| Medicare (plans) | $1,017 - $7,903 | 116% |
| Mercy Hospice Okc [20252] | $1,017 | 116% |
| Provider Partners Health Plans Contracted [320450] | $1,017 | 116% |
| Qual Choice Contracted [320325] | $1,017 | 116% |
| Tribute Health Plan Mcr Contracted [320338] | $1,017 | 116% |
| Tricare | $1,017 | 116% |
| UnitedHealthcare | $1,036 - $1,901 | 118% |
| Globalhealth Contracted [320145] | $1,038 | 118% |
| Cigna | $1,048 - $4,805 | 119% |
| Ambetter / Centene | $1,399 | 159% |
| Home State Health Plan Contracted [320187] | $1,399 | 159% |
| Novasys Contracted [320285] | $1,399 | 159% |
| Community Care Contracted [320080] | $1,555 - $5,532 | 177% |
| United Medical Resources Contracted [320454] | $1,901 - $5,137 | 217% |
| Health Choice Contracted [320166] | $2,035 | 232% |
| Healthsmart Preferred Care Contracted [320184] | $2,288 - $5,137 | 261% |
| Kempton Contracted [320214] | $2,288 | 261% |
| Medica Contracted [320239] | $3,027 - $7,903 | 345% |
| Healthcare Highways Plus Contracted [320175] | $3,082 - $4,742 | 351% |
| Webtpa Contracted [320417] | $3,319 | 378% |
| Osma Health Contracted [320292] | $3,556 | 405% |
| Aither Health Contracted [320449] | $4,742 | 540% |
| Auxiant Contracted [320462] | $4,742 - $5,137 | 540% |
| Benefit Management Contracted [320052] | $4,742 - $5,137 | 540% |
| Ebms Contracted [320493] | $4,742 | 540% |
| Healthlink Contracted [320179] | $4,742 - $5,137 | 540% |
| Imagine 360 Contracted [320494] | $4,742 | 540% |
| Mercy Benefit Admin Contracted [320251] | $4,742 - $5,137 | 540% |
| Quik Trip Contracted [320447] | $4,742 | 540% |
| Reflect Health Contracted [320492] | $4,742 | 540% |
| Show-Me Health Administrators Contracted [320483] | $4,742 | 540% |
| Workers Comp [20426] | $4,742 | 540% |
| Yuzu Health Contracted [320521] | $4,742 | 540% |
| Federal Medical Center Contracted [320127] | $5,137 | 586% |
| Healthscope Contracted [320182] | $5,137 | 586% |
| Healthsmart Accel Contracted [320183] | $5,137 | 586% |
| Point C Contracted [320238] | $5,137 | 586% |
| Preferred Health Plan Contracted [320522] | $5,137 | 586% |
| Tri State Healthcare Coalition Contracted [320379] | $5,137 | 586% |
| First Health Contracted [320128] | $5,256 | 599% |
| Private Health Care Systems Contracted [320320] | $5,927 - $6,322 | 676% |
| Preferred Community Choice Contracted [320311] | $6,006 | 685% |
| Multiplan Contracted [320270] | $6,322 - $7,113 | 721% |