Sleep study (overnight, in lab)
Facility: Wamego Health Center
Billing Code: 95810 (CPT)
- CPT Billing Code: 95810
- Insurance Median: $398
- Cash Discount Price: $1,174
- vs. Medicare Baseline: 0.45x 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 - $847 | 11% |
| Aetna | $97 - $881 | 11% |
| Medicaid / KanCare | $97 - $881 | 11% |
| Providrs Care | $146 - $719 | 17% |
| Tricare | $806 | 92% |
| Blue Cross Blue Shield | $2,496 - $2,642 | 284% |
Consumer Guidance & Cost Commentary
This report details the pricing for CPT code 95810, an overnight sleep study performed at Wamego Health Center in Wamego, Kansas. The facility's cash median rate is $1,174, which is significantly lower than the negotiated rates paid by major payers such as UnitedHealthcare ($93–$847), Aetna ($97–$881), and Medicaid/KanCare ($97–$881). For patients with high-deductible plans, paying the cash price of $1,174 upfront may be more cost-effective than relying on insurance, as the negotiated rates often exceed the cash amount. Additionally, the facility offers a prompt-pay discount for patients who settle their bill in full within 30 days, which can further reduce the final cost.
When evaluating the value of this service, it is important to compare rates against the Medicare benchmark rather than the facility's gross charge. The Medicare allowed amount for this procedure is $877.34, and the facility's cash rate is approximately 34% higher than this federal baseline. While the negotiated rates for commercial insurers appear lower than the gross charge, they still represent a markup over the Medicare rate. Patients should verify their specific plan details and ask the billing department about "self-pay" or "prompt-pay" discounts before scheduling to ensure they are not being charged the full negotiated amount. Always request an itemized bill to confirm that no unexpected ancillary services or unbundled charges are included in the final invoice.