Sleep study (overnight, in lab)
Facility: Centura St. Catherine-Dodge City
Billing Code: 95810 (CPT)
- CPT Billing Code: 95810
- Insurance Median: $5,923
- Cash Discount Price: $3,384
- vs. Medicare Baseline: 6.75x 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 675% of the Medicare baseline (a markup of 575%). 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Kansas Health | $448 | 51% |
| Aetna | $448 - $6,769 | 51% |
| Cigna | $448 | 51% |
| Medicare (plans) | $448 | 51% |
| Blue Cross Blue Shield | $448 - $7,192 | 51% |
| Kaiser | $448 | 51% |
| Humana | $448 | 51% |
| Centura Employee Plan | $785 | 89% |
| UnitedHealthcare | $5,567 | 635% |
| Wpaa | $5,923 | 675% |
| Christian Health Aid | $6,769 | 772% |
| Multiplan | $6,769 - $7,615 | 772% |
| Health Partners Of Kansas | $7,615 | 868% |
Consumer Guidance & Cost Commentary
For the CPT code 95810, representing an overnight sleep study at Centura St. Catherine-Dodge City in Dodge City, KS, the facility's cash median price is $3,384. This cash rate is significantly lower than the facility's typical negotiated rates, which range from $448 to $7,615 depending on the insurance carrier. For instance, while UnitedHealthcare and Wpaa have fixed negotiated rates of $5,567 and $5,923 respectively, the cash price remains consistently lower. Patients with high-deductible plans may find it financially advantageous to pay the cash price directly, as it avoids the administrative overhead often embedded in commercial negotiated rates. It is important to note that the facility's cash rate is also lower than the state average for this service, offering a more transparent baseline for self-pay patients.
When comparing this facility's pricing to federal benchmarks, the Medicare amount for this procedure is $877.34. The facility's cash price of $3,384 represents a markup of 6.8 times the Medicare rate, which is notably higher than the typical fair pricing range of 120% to 150% of Medicare. While commercial negotiated rates can reach up to 7,615, patients should be aware that these rates include administrative costs and contract dynamics that do not reflect the true cost of care. To minimize out-of-pocket expenses, consumers should explicitly request "self-pay" or "prompt-pay" discounts before scheduling, as these can reduce the final bill by 20% to 50%. Additionally, patients should avoid signing consent waivers that might inadvertently authorize balance