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GREAT answer, Blackneto!!

My numbers....

late 2007 initial dr. consult:
287 charge, 177 allowed by insurance
Since my annual deduction was met, I paid ~ 35 (20% of 177), and insurance paid ~ 142 (80% of 177).

late 2007 overnight sleep study, done in a hospital sleep lab:
2119 hospital charge, 1802 allowed by insurance
350 dr. charge, 272 allowed by insurance
Since it was all part of the hospital "stay," I paid nothing; and insurance paid 1802 to hospital and 272 to dr.

early 2008 OV with dr. to get sleep study results
147 dr. charge, 84.50 allowed by insurance
Since my annual deduction hadn't been met, I paid 84.50, and insurance paid nothing.

overnight titration study at same sleep lab (notice how everybody's prices went up w/ the New Year):
2435 hospital charge, 2069 allowed by insurance
400 dr. charge, 292 allowed by insurance
Same principle as the sleep study... I paid nothing; and insurance paid 2069 to hospital, 292 to dr.

OV w/ dr. to get titration study results:
147 charge, 84.50 allowed by insurance (this one's tricky)
I paid 44.80, which is 15.50 (the completion of my deductible, which reduced the allowable to 69.00) plus 29.30 (20% of the NEW allowable of 69.00). That's right, I paid about 53% of the ORIGINAL allowable.
Insurance paid 55.20 (the rest of 84.50).

So for the consult, sleep study, after-study OV, titration study and its after-study OV:
-- the hospital got 3871 from insurance
-- the dr. got 761.20 from insurance and 164.30 from me

At 2008 prices, for each sleep study, including the follow-up visit:
-- the hospital will get 2069
-- the dr. will get 376.50

Since my dr. refuses to write an APAP script (do NOT get me started), and since I can’t swing paying for one on my own at this point, they’ll probably “earn” that several times over during the year. He’s already ordered another overnight titration study for next month. (Yes, I am saving my pennies!!!)

No, I am absolutely not complaining. Any thoughts I had of feeling sorry for myself because of the $$ I’m forking over for the dr. and the equipment flew out the window when I read some of your numbers. Aargh. When I’m rich, I’m gonna start a foundation. Don’t hold your breath. (oops) (ha) (get on the hose)

Marsha

I just pulled up my medical claims for the sleep study and equipment and here is what I found:

My insurance was billed $2,250 for the sleep study; they paid $750 and fortunately, I am responsible for paying $0. The healthcare place where I got my equipment charged $1,301.75 ... the insurance company paid $1,156.95 and I am responsible for the $20 co-pay for which I have yet to be billed. This has all happened in the past three weeks and I'm very new to it all!

Here's the breakdown from my insurance paperwork. I had my sleep study 4/13/07

2,540 billed
-508 insurance excluded
2,032 eligible for payment

My insurance paid $1,425.60, and I paid 606.40. My insurance would have paid 80%, but I hadn't met my $250 deductible by then. This was a sleep study at the hospital.

Amazing to see how these costs vary across the country...

Going back to my original post - I did make one error - I checked the bills again and though the sleep clinic billed the insurance company approx $6500 for each sleep study, the insurance company cut it down to about $5700, of which they paid 90% & I have to pay 10%.

Still quite a lot of money, but at least my insurance covers the 90%

I am in the CA Bay Area, which is probably why it is so high

I've been fighting with the insurance company to give me a sleep study for the past two years. I have filed numerous appeals. No study. It looks like I will have to pay for it myself. Good Old USA and healthcare. I'm hoping when I get it done and it shows I do indeed have Central apnea, they will pay for any other procedures I might need to find out the cause (MRI, etc.) and any equipment I might need VPAP, etc.

I have been to a neurologist, a gastro (stomach docotor), an eyes, ears, nost and throat guy. They just look at you and tell you you have anxiety and take Lexipro and prilosec.

I now have depression and am at my wit's end.

I asked my primary care doctor to refer me to a specialist for another sleep study (I had not had one in six years). The sleep lab was located in an in-network hospital and the charge was $5,373, of which the insurance allowed and paid $3,385. I had only to pay my $30 co-pay to see the specialist because the lab was in-network but nothing out of pocket for the study itself as it was considered no different than going to a lab for blood work.

I did have to pay 30% of the total cost of my bipap, mask, etc. as that is the percentage I would owe for any durable medical equipment. I have Blue Cross, basic option.

This thread is kind of like asking the bank robber what his take was, every bank gives different results. I usually don't get a bill for anything, I have a $20 co-pay on Doctors, and a $5 co-pay on prescriptions @ 90 day supply. The result of good INS, obtained by the sweat of my brow, and that took some health away. Jim

Mine was $2600. at the sleep lab in 2003, but the chariety hospital where I go paid it in full, or I'd be washing masks in the kitchen . I lucked out in that a sales rep for cpap equipment bought a house next door for a rental and he has kept me supplied in masks and hoses since 'o3 at no cost to me. I bought a Remstar/pro for $1.00 at the local thrift store, less than 200 hours on it. Good clean heathern living I guess
I am awaiting a second appointment at the sleep lab. I bet it has gone up a bit.
Tansey

Sleep lab billed INS $3760. INS paid $950. I paid $0.
Sleep Dr (not my ENT) billed INS $257 for analyzing data. INS paid $257. I paid $0.

My hubby has Blue Cross Blue Shield of Florida...with a 1500.00 deductible, we have met it by paying our share of the study (our cost 680.00) and getting the machine, with all the accessories. Now that his deductible is met, he may have his tonsils removed. he is going back to doctor next week for follow up

$6500 in Boston (Tufts/New England Medical Ctr)

Boy there is a big difference in prices, If you don't have insurance it would really pay to shop around.

I have been offline for a couple of days and before that had not seen this post. I am in Illinois..small town but good hospital and my sleep study was$ 3,300. I am getting ready to have a titrated study at a different lab later in the month. What is funny is that earlier in the day I sent a PM to Blackneto in Normal Illinois..He is only about 35 miles from me in the town am having the sleep study in..I only sent it private because while we may critisize our DME'S and docs we normally don't put out the actual names and my theory was he could be totally honest that way ! No don't get me wrong..so far this doc has been great..wish I had gone to him first , but a second opinion is always good..now I find out Black is a rep of some sort ! This means only one thing..bigamy or not I get to marry him and not Slinky because I live closer !

Guess I forgot to login..
Illinigal

Cheat, cheat!! No way, IlliniGal! I've got first dibs on BlackNeto. I asked him first! Keep yer grubby hands off!

Okay, I can access my claims online so I just checked to see what it cost.

Sleep study: billed $3,8000, In network price - $2,973.10, Paid to Doctor: $826.90

Interesting, I don't owe anything on it. Its one of those insurance things where a ton is billed in order to get a little. So far, my only costs have been $75 worth of co-pays ($20 a shot)