Average co-pay for sleep study?

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Average co-pay for sleep study?

Postby SleeplessinPennsylvania » Tue Apr 25, 2006 8:59 pm

Just wondering what some people's co-payments have been for a sleep study, and then the CPAP and other equipment. I strongly suspect sleep apnea, and plan to get evaluated for it soon and just want to know for planning purposes.


Postby Linda » Tue Apr 25, 2006 9:55 pm

I don't recall any co-payments through my insurance for the study, come to think of it. Not even when I got my cpap through insurance.
And I don't think I had such a great insurance coverage.
But you should find out ahead of time if you are at all unsure.

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Postby SleeplessinPennsylvania » Tue Apr 25, 2006 10:54 pm

I'd better rephrase. What is the actual cost of the sleep study? If I have a PPO and I must pay 10% of all sleep study costs, up to $1,200, and I am wondering how much it will cost. I'm switching jobs and insurance, so I can't call to specifically ask how much it will cost yet.

Postby another_guest » Tue Apr 25, 2006 11:01 pm

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Postby Napster(the former) » Wed Apr 26, 2006 10:48 am

I had a sleep study as a result of a bad EKG during my annual hazmat physical (even though I had ignored input from my wife for years--what a fool I was). But here is the rundown.

HazMat Physical--paid for by employer
Regular Doc evaluation of HazMat physical--$10.00 copay
Stress EKG at cardiologist--$10.00 copay
Consult with reg doc about stress EKG--$10.00 copay
Consult with cardiologist about stress EKG--$10.00 copay
Nuclear material injected into my veins simultaneously with another stress EKG--$10.00 copay
Consult with cardiologist about above--$10.00 copay
Consult with reg doc about cardiologist recommendation to have sleep study at HIS sleep center--$10.00 copay
Sleep study at hospital (not cardio's) sleep center--(ho hum) $10.00 copay
Sleep study for titration--$10.00 copay (note: my reg doc, a golf partner, called and said she could do without the $10 copay because she thought she could get it from me on the golf course and not have to pay taxes on it, LOL, she hasn't yet.)
All the stuff (blower, hoses, head piece, etc.) you guessed it $10.00 copay

Lost part to be supplied by DME at some time in the future, perhaps before the rapture, perhaps not--$10.00 copay

Lost part bought with a credit card over the internet, delivered in 16 hours--$25.00

That brings the total to about $135.00, and it has been worth all my worldly goods and assetts, except my golf clubs, for the 220 (or so) good nights of sleep.

Go for it, borrow the money from a loan shark, or worse yet a relative, but your life will be changed.
Check your smoke detectors and make sure the batteries are fresh.
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Postby another_guest » Wed Apr 26, 2006 11:43 am

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Postby MelindaR » Wed Apr 26, 2006 12:58 pm

Things do vary by insurance coverage and area:

Sleep study done in a hospital (so billed as hospital visit) was $1,600, though insurance only ok'd $800 of which I had to pay $300 to meet my deductable (of $250).

Reading of the sleep study was $325, which I had to pay the full amount. The dr. was considered out of network and so this amount went to the deductable (which is $500). I was so not pleased with this amount.

APAP machine - DME wants to charge $1250, though insurance is only ok'ing $860. Of this I have to pay 50%, though since it's a 10 month rental I'm stuck paying my deductable again before the insurance kicks in. So I will have paid $560 for this machine. Humidifier was billed separately and charged first thing. The DME tried to charge $300, though the insurance only ok'd $150 so I have to pay $75.

I sure would have been happy with a $10 co-pay or even paying 10%. Of course, even with the horrible costs, it's worth it.

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Postby ChadTower » Wed Apr 26, 2006 1:15 pm

From the insurance reimbursement form from my first study:

Sleep study cost: $3200
Agreed upon cost to insurance: $760

My portion of that, according to my coverage, is 20% of that $760.

So, to review, if I were a person who could not afford insurance, it would cost me $3200 for something that only costs the insurance company $760.
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Postby NightHawk777 » Wed Apr 26, 2006 1:24 pm

I had a sleep study on 2/23/06.

It was at a hospital facility.

They billed Aetna $4,475.
Aetna had negotiated the price to $2,170.37
The plan paid $1,935.74, which left me owing them $215.08.

I believe all these prices are subject to change based on your insurance company, your regional location, etc etc.
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Postby ChadTower » Wed Apr 26, 2006 2:19 pm

I find it offensive that the medical providers charge an insurance company so much less than they charge an individual. Logistically it does make some sense, but the fact the remains that once again Average Joe takes it in the keister.
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sleep study cost

Postby zzz chaser » Wed Apr 26, 2006 3:23 pm

my sleep study (march 31st,dying for the results back) was at a hospital. they wrongly filed the claim to blue cross.blue cross said i was liable for entire cost $3707 :shock: Called the hospital.had them refile claim to my primary insurance GHI. waiting to see how it plays out. I feel terrible for folks without health inssurance. (according to article on msn.com 40% adults have on health Inssurance in the usa)
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Postby Nightwing » Wed Apr 26, 2006 6:22 pm

Mine was around $2,000 and I had to pay 10% ($200).

My CPAP machine is costing me $19 a month after an initial outlay of $50. After 10 months, however, I own the machine and the monthly payments will stop.
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