Sleep study (overnight, in lab)
Facility: Ascension Via Christi Hospital Manhattan, Inc
Billing Code: 95810 (CPT)
- CPT Billing Code: 95810
- Insurance Median: $941
- Cash Discount Price: $1,174
- 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 |
|---|---|---|
| UnitedHealthcare | $93 - $2,635 | 11% |
| Aetna | $97 - $881 | 11% |
| Medicaid / KanCare | $97 - $881 | 11% |
| Providrs Care | $146 - $719 | 17% |
| Tricare | $806 | 92% |
| Va | $941 | 107% |
| Humana | $941 - $950 | 107% |
| Medicare (plans) | $941 - $960 | 107% |
| Smarthealth | $1,023 - $1,317 | 117% |
| Ambetter / Centene | $1,600 | 182% |
| Blue Cross Blue Shield | $2,496 - $2,642 | 284% |
Consumer Guidance & Cost Commentary
For the sleep study procedure (CPT 95810) at Ascension Via Christi Hospital Manhattan, the facility's cash price of $1,174 is significantly lower than the negotiated rates charged to most insurance plans, which range from $93 to $2,642 depending on the carrier. While the facility's negotiated average of $941 is lower than the gross charge of $2,936, it remains higher than the cash option, illustrating that paying out-of-pocket can sometimes be more economical for patients with high-deductible plans or those without insurance. The facility's cash rate is also notably lower than the Medicare benchmark of $877.34, suggesting that the commercial negotiated rates include substantial administrative markups typical of the healthcare system. Patients should verify their specific plan's allowed amount, as some insurers may pay less than the facility's listed negotiated rate, potentially leaving them responsible for balance billing if they are out-of-network.
To minimize unexpected costs, patients should proactively request a prompt-pay discount or self-pay rate before scheduling, as these upfront payments often bypass the complex insurance billing cycle and associated administrative fees. If a patient receives a bill after insurance submission, they should request a full itemized audit to identify any errors, unbundled codes, or services not rendered, as over 80% of hospital bills contain inaccuracies that can be corrected. It is important to note that while the No Surprises Act protects against balance billing for emergency care and non-emergency services from out-of-network providers at in-network facilities, patients should still review their specific contract terms and avoid signing away their rights to dispute out-of-network charges without understanding the implications. Always confirm with