Sleep Study Cost

Just comparing costs here...

What type of sleep study did you have most recently and what was the total cost before insurance? Mine was a BIPAP study with backup rate, if needed, and it was $4,000+. My previous study was a CPAP titration study and it was $2,500. Both were done at in-network providers.

Are the above amounts the billed amount or the allowed by your insurance company amounts?

My first sleep study coming on 8 years ago in April was the diagnostic sleep study without mask....$2700 and the coming back for the second night of cpap titration was $2900. Those were the billed amounts...I have Medicare and the actual allowed amount was much less but I don't remember how much less and I never got a bill for either stating my portion of the final allowed amount.
Any copays that are your responsibility will be based off the contract/network allowed amount and not necessarily the billed amount.

I am not surprised that the bilevel titration cost more. There's more detailed work involved.

my sleep study cost $3800.00

my titration sleep study was $6500

at least, these are the amounts the hospital billed out.

this was in chicago, il.

for comparison...a 10 minute EVP test was $985.00

my MRI's have varied between $1500 and $6000 depending on where i had them done.

for decades i had blue cross insurance, and it ran me about $500 a month. it was decent, but the deductibles were high, as were the copays. i literally never had a single claim in almost 20 years other than my yearly check up and an albuterol inhaler i have had since i was 12.

my first MRI under blue cross still cost me $2000. it was billed at almost $5800. it was a full head and spine MRI.

i tried to get a sleep study a few years ago and was told at the time my insurance would not cover it unless a doctor specifically required it. i could never find a gp that would do this for me. they just kept giving me meds.

i finally found a neuro who is helping me.

in the last few years i have gone bankrupt and am not working due to my health issues.

but, luckily i was able to secure affordable insurance through the ACA last year.

i'm on illinois health connect thru obamacare, which essentially is run by medicaid.

they will cover most of these costs, the down side is the wait time for help, getting referrals, finding docs that will take my insurance card.

the other issue is waiting for them to approve things. it took me 4 months to get approval for the sleep study, which i finally had in november last year.

i had my titration on jan 3. my doctor gave me an Rx for CPAP on jan 5.

the DME called me on jan 9th and told me they would get me a CPAP as soon as my insurance approved. i was so excited to finally have something i could directly address after almost a decade of increasingly worse health issues and no help.

the DME called me back one month later and told me medicaid in illinois is way behind on approvals. it would likely be end of march before i could get a machine.

they called me back 4 more times in the past few months. now it looks like end of may or even june before they will approve my CPAP gear and get me equipment.

i decided i could no longer wait. i bought my own machine and mask and found this forum, trying to do this on my own.

i feel incredibly bad for folks that have to wait for help for more severe conditions. i'm in bad shape, but i can still function. some people have life threatening issues and have to wait for insurance approval to get help. that is just wrong.

the health care and health insurance system is a mess. it is difficult to navigate for even the most lucid and intelligent person.

over the past 10 years i've gained a new appreciation for the struggles so many people face in this country when they get sick.

I recently got a Level 3 Resmed Apnea Link Air study.
It is a home study done using the Apnea Link system with the data sent off to a sleep doctor.
It was free.
I read online somewhere that a study was done to compare this type of study to a Level 1 study. It compared favourably. I am not sure if I need to push for the level 1. In Canada, it takes a lot of time to get in for the Level 1, but it's free.

My sleep study was billed through Medicare - I don't remember the fantasy price, but the actual paid was about $800. Titration was the same.

My PCP first ordered a home sleep study that was billed to the insurance company as an "office visit" so my co-pay was $30. This same doctor belonged to a large medical facility that also had a sleep center in the building. Again, they billed my overnight sleep study as an "office visit" and again my co-pay was $30. Total costs for both studies was $60. I still do not understand how they pulled this off, but cannot complain. Sadly, this doctor and his entire facility, was "ObamaCared" soon after my sleep studies so I never saw him again about two years ago. Remember "keep your plan, keep your doctor", yea right.........

Looks like I had zero copay for my split sleep study, base cost of $4500.

I also had zero copay for my colonoscopy the same year... I think my insurance had a special section for no-copay preventative health care.



RESPIRATORY MEDICAL GROUP $430.00 $25.00
SLEEP CENTER $4,500.00 $0.00
RESPIRATORY MEDICAL GROUP $182.00 $25.00
OXYGEN PLUS INC $753.60 $468.56

I had an overnight sleep study in N.Y. City on 11/24/2015. The amounts are shown below.

My apologies for an earlier posting that I deleted. There was some confusion because the sleep lab sent a duplicate bill to the insurance.



Amount Billed $4,530.24
Plan Discounts $1,851.93
Your Plan Paid $2,678.31
Your Responsibility $0.00

Every insurance Policy is different. AHCA or Obama care setup a Bare minimum plan that only set a baseline that all Health insurance plans sold in the USA had to cover. From their the plans could add expanded benefits with higher premiums.
It all depends on your personal and plan deductibles before your costs are even covered.
After your deductible is met you in many cases have a Percentage that your insurance covers, most are 10-20% of the plans negotiated costs.
You will also likely have a insurance plans Max yearly out of pocket cost, once you have met that all covered costs are paid in full by the insurance company.
I think it's a good idea for everyone to get what they need this year medically from their current insurance plan as next year it will likely be a whole different situation under the New American Health Care plan. Thoes that are working and on employer health plans should be ok.
If your like me and purchasing a Private plan at age 56 your likely to be in a very bad place. I was caped at 3 times the cost of a younger persons insurance under AHCA but under the New proposed American Health Care plan i will be paying 5 times as much in Premiums. I don't think I can afford that with my Pension and will have to stop buying health insurance and hope for the best.
The emergency room worked for people before ACHA so I guess that will have to be my new backup plan.
mostly my fault as I should have applied for Disability instead of trying to be proud and taking my early retirement when I could no longer perform my job duties.

jtravel wrote:Every insurance Policy is different. AHCA or Obama care setup a Bare minimum plan that only set a baseline that all Health insurance plans sold in the USA had to cover. From their the plans could add expanded benefits with higher premiums.
It all depends on your personal and plan deductibles before your costs are even covered.
After your deductible is met you in many cases have a Percentage that your insurance covers, most are 10-20% of the plans negotiated costs.
You will also likely have a insurance plans Max yearly out of pocket cost, once you have met that all covered costs are paid in full by the insurance company.
I think it's a good idea for everyone to get what they need this year medically from their current insurance plan as next year it will likely be a whole different situation under the New American Health Care plan. Those that are working and on employer health plans should be ok.
If your like me and purchasing a Private plan at age 56 your likely to be in a very bad place. I was caped at 3 times the cost of a younger persons insurance under AHCA but under the New proposed American Health Care plan i will be paying 5 times as much in Premiums. I don't think I can afford that with my Pension and will have to stop buying health insurance and hope for the best.
The emergency room worked for people before ACHA so I guess that will have to be my new backup plan.
mostly my fault as I should have applied for Disability instead of trying to be proud and taking my early retirement when I could no longer perform my job duties.

Note that my Sleep Lab would bill $4,530.24 to any insurance plan. They might take less in the end depending on one's insurance.

.

My 3 night at-home sleep study was paid for by my ins. I owed nothing out of pocket. I did not have a titration study, I got that done for free by the good folks here. I did not see a sleep specialist to get diagnosed, just my PCP.

My Sleep Study done by Guthrie in Pennsylvania May 3rd 2017. I was in for 1 night. Just received the bill... My insurance company is Blue Cross. coded as 920 General for 7,753.36 Insurance paid 5,863.97 and my payment due after insurance is 1,889.39

Manteca California - Kaiser

Finger PAP (take home)
Total cost: $546.00
My Cost: $40

Overnight Titration Study
Total Cost: $2,066.00
My Cost: $40

And the cost for my AirCurve 10 VAuto, hose, and Simplus Mask was $0

Unfortunately, it is near impossible to be a responsible consumer with the structure of health care pricing. Since the prices that are stated are negotiable for a cash customer and meaningless for insurance, there is no way to tell the real price of any service. Insurance companies and the government like to say we need to be responsible consumers and price shop, but sine the price quoted is often 2x the amount actually paid, and the amount paid is closely held if not an outright secret, leave us no option but to pick who we like, and go from there.