(Update 2022) Daytime dozing, excessively loud snoring and fitful sleep are all reasons to have a sleep study. So how much does a sleep study cost? The answer: it depends. Keep reading for more information and advice.
There are several different types of sleep studies. ClearHealthCosts researched the most common ones. A polysomnography (medical code 95810 or 95811) is a baseline test most often used to diagnose sleep apnea. A PSG monitors a number of physical activities during sleep, including nasal airflow, snoring intensity, body position, heart rate, eye movements, muscle activity and heart rhythm.
We found PSG prices range widely. At several New York area providers, a basic sleep study, or polysomnography, costs $600 or $900 for a cash or self-pay patient. But at some places the price is $5,000 and up. The highest price we found was $6,177 at the Sleep Center at Greenwich Hospital in Greenwich, Ct. — with interpretation and doctor’s fees separate. (The actual test is polosymnography; the result is a polysomnogram.)
In New Jersey, we found that Chilton Hospital’s Sleep Health Institute charges $4,200 for polysomnography. The Center for Sleep Medicine at St. Claire’s Hospital bills $1,200 for the same medical code. The bill from Trinitas Regional Medical Center in New Jersey for a cash or self-pay patient would be closer to $5,070.
Two other common kinds of sleep study
Another common test is a split-night study (medical code 95811). It combines a PSG and a continuous positive airway pressure study, or CPAP. The first half of the night is just a basic PSG. If sleep apnea tendencies are exhibited, the patient is woken and is fitted with a mask and hooked up to a CPAP machine. During the second half of the night, a CPAP titration test monitors airflow with the device.
In some cases the split-night study was slightly more expensive. For a cash or self-pay patient, Summit Medical Group charges just over $2,700 for a PSG and $3,150 for a PSG with a CPAP. But Hackensack University’s Institute for Sleep/Wake Disorders charges $1,900 for each procedure, again for a cash or self-pay patient. The highest price we found was $7,801 at the Sleep Center at Greenwich Hospital in Greenwich, Ct. — with interpretation and doctor’s fees separate.
It’s not clear that every provider is consistent about using the same medical coding practices, which is particularly true here. Online communities discuss what is a 95810 and what is a 95811, so if you’re confused rest assured that others are too. Here’s a page online discussing medical coding for sleep studies, in which several people relate how they do it. The differences are striking.
Here’s a page of New York area polysomnography sleep study fees for a cash or self-pay patient. Here are New York area split-night sleep study prices.
Here’s a page of Los Angeles area polysomnography sleep study fees for a cash or self-pay patient. Here are Los Angeles area split-night sleep study prices.
Here’s a page of Dallas-Fort Worth area polysomnography sleep study fees for a cash or self-pay patient. Here are Dallas-Fort Worth area split-night sleep study prices.
We also priced the Multiple Sleep Latency Test (95805), which is used to diagnose other sleep disorders, including narcolepsy. Performed during the day, it measures how quickly a patient falls asleep in a quiet environment. It generally consists of four or five scheduled naps every two hours. The Maintenance of Wakefulness Test, or MWT, is another daytime test. It measures how long a patient stays alert in a dim room. Both tests have the same medical code.
These daytime tests can be less expensive than those performed in the evening. New Jersey’s Center for Sleep Medicine at St. Claire’s Hospital fee is $850, while Trinitas’ bill is $4,158 for a cash or self-pay patient.
Here’s a page of New York area prices for a Multiple Sleep Latency Test for a cash or self-pay patient. Here’s a page of Los Angeles area prices for a Multiple Sleep Latency Test for a cash or self-pay patient. Here’s a page of Dallas-Fort Worth area prices for a Multiple Sleep Latency Test for a cash or self-pay patient.
The Mayo Clinic is a great site for in-depth medical information. Here’s their page on polysomnography, and this page tells a bit more about a split-night study. Here’s a bit about multiple sleep latency testing.
The prices we list here reflect only the cost of the test. Other fees generally apply. (Pro tip: on our “results” pages, the “notes” field gives extra information, as much as we know, about extra charges. Just click on the word “notes.”)
If patients are referred by a primary care physician, an initial consultation may not be required. But if you weren’t referred, Health Bridge Sleep Medicine in Manhasset charges an additional $250 for an initial visit. At Montefiore Medical Center, a consult ranges from $300 to $600. But at the Sleep Disorders Service in Kew Gardens, that fee is included in the amount charged for the test.
Where is the test performed? That often affects the SLEEP STUDY COST.
Sleep studies can be performed at home, at an independent sleep study center or at a hospital. While we did not price the at-home procedures, we found that the location of the sleep study affects the price.
Patients having a test at an independent sleep study facility could save money–sometimes. The sleep center might charge a facility fee in addition to the test. Sometimes the fee is bundled into the price of the test, sometimes it’s a separate charge. If the test is performed at an affiliated hospital, the hospital also charges a facility fee.
Since a sleep study produces reports, there is often a report interpretation fee. This might generate two bills, one from the sleep technician and another from the doctor. Most centers declined to give specific amounts on interpretation fees, but one reported that they could be $200 or more.
Generally, a sleep study is beneficial if it is done with a history-interview type of study of how you sleep — when, where? Do you eat before going to sleep, watch television, etc.? Your sleep patterns are important when combined with a sleep study to diagnose problems and suggest treatment.
How it can all go wrong
Sometimes this process is smooth. Sometimes it goes completely wrong. Here’s a community member’s story, shared via our software.
“My husband has sleep apnea. His cpap machine of many years broke and to get the insurance to pay for a new one dr Bashir said my husband would need a sleep study done, also because it had been years since his first sleep study and he gained weight.
At this appointment my husband told the doctor that he had already bought a cpap machine anyway because he had to wait a month for the appointment and he couldn’t sleep without it. All he needed was a particular number so the insurance company would count that cost in our out of pocket. My husband was clear about why he was there. He was doing fine with the cpap machine until it broke.
“The doctor said that to give him that number my husband would need to use this particular sleep study machine for one night at home and the number would come out of that. The cpap machine my husband had already bought was $400. We didn’t know at the time but that appointment was $489 and we paid $219.14 of that. The appointment after the sleep study was $244 and we paid $84.07. We got an explanation of benefits for a electroencephalogram amount billed $1,324.00 , discount of $423.68 and our part was $900.32.
“I called the insurance to explain that this was wrong. I told them what was done and they said that it could be billed with that name.
“I called around and found out that the procedure code 95806 costs no more than $280. One place said $203.69 without insurance. OMG. I called the billing department told them what’s going on and they said there wasn’t a mistake on their part and we had to pay. They said they could set a monthly payment plan.
“I said that my point here is that I think you made a mistake. How could you charge this much when it costs so much less everywhere else? She said that they didn’t make a mistake. I called St Mary’s patient advocate and the woman said there was nothing they could do.
“After some research I found that I could ask for a audit to be done. I did ask. About 2 weeks later I received a letter that says that ‘ they (Bon Secours) maintain billing practices that are in line with competitive market charges ‘. They all talk about a payment plan to help, ignoring the fact that it’s not right to rob me so openly and get away with it. They got away with it. We had to pay.”
How much does a sleep study cost? The takeaway.
The price range is huge. As always, if you’re insured, make sure it’s covered, in network, and so on. Here are some questions you should ask.
- Be sure that you need a sleep study, and know which kind is being recommended (and why).
- If you’ve got health insurance, will the sleep study cost be covered by your insurance policy? We have heard that doctors’ recommendations are sometimes rejected for payment after the fact by insurers. Always ask first.
- We recommend that you shop around. If your provider sends you to a facility, ask if it takes part in your insurance plan–if it’s in your network.
- Ask how much the sleep study cost will be. Ask how much it will cost you. You can also ask if there’s a lower-priced alternative that will deliver the same results.
- Ask: what is the total charge? Are there facility fees, lab tests? Is there an interpretation fee? A reading fee? Does the doctor charge a separate fee?
- How much are initial and follow-up visits? Will they be covered?
- Reddit can have a lot of interesting first-person information about such topics. Try these subreddits: r/SleepApnea, r/Nosleep and r/insomnia.
- This guide to interpreting results is fairly thorough. The American Sleep Association, a trade group, offers these details about sleep studies.
We know this can be bewildering. But it’s up to you to ask these questions. This is why it is always important to know your insurance plan thoroughly if you’re insured.
Even if you’re insured, you might be on the hook for a lot of money if you pick the $3,500 sleep study. If you’re uninsured or on a high-deductible plan, it’s even more important. If you have questions, ask.
Next: How much does a sleep study cost? One woman’s story.
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Related posts:
Part 1: How to find out what stuff costs in health care.
Part 2: How to argue a bill.
Part 3: Appealing a denial, or how to turn a “no” into a “yes.”
