Has your doctor ordered a test, medication or specialist visit but can’t tell you what it’s going to cost?
Have you ever been surprised by a huge medical bill when you thought you were covered?
Have you ever postponed a procedure because you weren’t sure what it would cost you?
Have you ever been confused about your insurance coverage for a service that you really needed?
Figuring out the price and your financial responsibility for a sleep study can be a challenge. We’re here to help answer your questions.
Sleep studies don’t have to be expensive.
There’s a big price range depending on the type of sleep study (in-home or in-center), the type of center (do they bill separately for the study and its interpretation?) and your insurance. Most health insurance plans include coverage for sleep studies with certain providers (see the next section below).
An in-center sleep study price tag can range from $500-$3,000. If you have insurance coverage, you choose an in-network provider and you have met your deductible, your financial responsibility may be $0-$150. That’s the average we see (again, read more about deductibles and more below).
For out-of-center of in-home sleep testing (HST), the base rate ranges from $300-$600. If you have insurance coverage, you choose an in-network provider and you have met your deductible, your financial responsibility may be $0-$50.
Here’s a great site clearhealthcosts.com where you can search average costs for medical procedures in each state.
What you need to know about health insurance coverage for sleep studies
The rate you pay for your sleep study depends on the relationship between the sleep center and your insurance company (if you don’t have insurance or elect to pay a cash rate, you can expect to pay anywhere from $700-$3,000 for your in-center study). Your insurance company will contract for services with providers at greatly reduced rates. So it’s important to understand your coverage. There’s a big difference between the price you’ll pay for going to a contracted or in-network provider vs. one who will “accept” your insurance but isn’t contracted. For you, this could mean the difference between paying $150 and $1,200 for the same procedure. We’ve devoted an entire post to this topic here.
You’ll need to know if you have a deductible to meet before your insurance coverage kicks in. For many patients, deductibles can be as high as $2,000 to $4,000 or more. So while you have coverage for the service, you have to pay out-of-pocket until you meet that deductible.
If you’ve met your deductible, your insurance will pay for a covered service, but may not pay 100%. Again, be sure to find out the difference between coverage for an in-network vs. out-of-network provider as in-network coverage could be 80-100% while out-of-network coverage is 50% or none at all. We see typical in-network co-pays are around 20% and end up as a $100-200 charge for the patient (here’s a link to our Guide to Understanding Your Health Insurance).
You should also keep in mind that there may be additional expenses down the road if you are diagnosed with sleep apnea. You may need additional sleep studies or a CPAP (which requires regular replacement of supplies). We talk more about follow-up expenses later in the post. Just keep in mind that all of these expenses will get you closer to meeting your deductible, the point where your insurance will really kick-in and reduce your out-of-pocket expenses.
How to find a contracted sleep study provider
You can always call your insurance company to ask (good luck) or check their member services portal online. Search for “sleep center” or “sleep lab” and make sure to choose the “facility” option. You can also choose facility and search “sleep”.
Or you can search online for local sleep centers (here’s a listing site) and contact them to find out if they are contracted with your insurance. Be sure to ask if they are in-network. Be very clear and ask for a clear answer. You should ask the sleep center to verify your insurance and give you an estimate of your financial responsibility.
We have a full list of all of the insurance plans and medical groups that we are contracted with for all services. You can download it here.
Alternatives to an overnight in-center sleep study
Out-of-center sleep apnea test, aka home sleep test (HST)
This is a self-administered option for patients without other major health condition who want to diagnose or rule out sleep apnea. HST cannot test for any other sleep disorders and may sometimes lead to an in-center test anyway. Some insurance companies are denying in-center testing in favor of HST because it is much less expensive and can sufficiently diagnose sleep apnea in most patients. Learn more about HST here.
Lose weight
If your doctor suspects that you suffer from sleep apnea and you are overweight or obese, losing weight may help to reduce or eliminate sleep apnea. Losing weight may be one solution, but it takes time and is a challenge for many people. While you are trying to lose weight, you may wish to treat your sleep apnea at the same time. This is really important stuff here, so please talk to your doctor.
Do nothing
Doing nothing is also an option. We’ve spent a lot of time talking about the consequences of untreated sleep apnea to your heart, brain, diabetes, reproductive system, relationships, family life and overall life satisfaction. If you don’t treat your sleep apnea there are serious consequences. You will end up paying in the long run.
What expenses to expect AFTER your sleep study
If you’re diagnosed with a sleep disorder, like sleep apnea, there may be additional expenses that you should expect. First, depending on what type of sleep study your physician orders (learn more about the different types of sleep studies here) you may need to return for a second overnight sleep study to determine the optimal pressure settings for CPAP therapy (learn more about CPAP therapy to treat sleep apnea here). In some cases, you can skip the in-center titration and opt for a CPAP device that adjusts the pressure setting throughout the night (learn more about APAP here), but this may not be appropriate for you depending on the severity of your disease and other factors.
If you are prescribed CPAP therapy (this includes APAP or bi-level/BiPAP) you can expect to have to pay for either the purchase or rental of a new device (learn more about insurance coverage for CPAP here). Additionally, the accessories that come with the machine- the mask, cushion, tubing, filters and water chamber- need to be replaced at regular intervals which your DME company can ship to you at regular intervals, usually every three months (learn more about when to replace your supplies here).
The scariest thing about a sleep study for most people is not knowing what to expect you’ll have to pay. Sleep studies can be expensive but they don’t have to be. Understanding your health insurance coverage and your options for testing (in home vs. a sleep center) can help you make a decision that fits your budget. And don’t forget that the cost to your health of doing nothing at all may be the most expensive decision you’ll ever make!
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Comments
Anne
Posted on March 05, 2018Thanks a lot.
Jennifer Aldridge
Posted on April 25, 2018Hi, my husband had a recent 5 day stay in the hospital due to breathing issue’s. We found out that he had chf and atrial fib. All due to sleep apnea. He is only 43 yrs old. We do not have health insurance and the doctors say his condition is very severe. His oxygen levels drop as low as 59 and his heart rate starts going up to 180 while sleeping due to the sleep apnea. We are currently borrowing a machine from my sister, and I have a start on trying to get help getting our own machine thanks to this website. My question is….. they want to do sleep test on him, they have yet to do one, and there is no way we can afford. I don’t know how we are going to afford the program fees to even get a machine. On top of a 5 day hospital stay $100 mask we had to buy for machine and $150 prescriptions being filled. Is there programs that help pay for the sleep test? Please help this is literally life or death one night one breath at a time. I don’t sleep because I’m constantly checking on him. He don’t sleep because he is scared. the drs keep reminding us how important it is to get test done. We know it is just isn’t anyway we can afford it.
Sandy Deaton
Posted on May 01, 2018Jennifer Aldridge, see about getting an HST test. It is done in home and will cost about $200. At least that is what we charge in my office. For a CPAP machine and supplies look into sleepapnea.org. They may be able to set him up on an auto pap machine. and supplies are much cheaper.
John
Posted on July 10, 2018My first study cost $7500 and second one, to “set pressure” cost $8000. I had to call to get that info. This seems very excessive, even though I was assured Medicare would cover and my personal cost would only be about $200. The room was in an office building and was small and unsanitary. Suggestions?
Scott
Posted on March 26, 2022The cost is exorbitant and typical of the entire medical profession. Don’t worry, though, because the corrupt, money-grubbing medical industry is close to suffering the consequences of its greed and lust for money. Why? Because the financial system is about to collapse. It’s a mathematical certainty that this will happen. Greedy doctors, medical service, and product stakeholders are in for a rude awakening. I doubt they have taken the necessary measures to mitigate the economic fallout from the events about to commence with force and violence. Soon, they will not be able to afford essential medical services and will have to live and suffer from ailments that can’t be treated because the costs will be too high. Does this sound familiar?
Reggie Joseph
Posted on September 26, 2018Hello Ms. Jennifer Aldridge.
I just saw your post. If your husband has not yet done his sleep study I can help. If you can make arrangements for your accommodation and flight to Houston, I can do the test for free for you at my Sleep Lab. I can also provide a used CPAP machine, at no charge, for your husband.
Just trying to help.
Reggie Joseph, RPSGT.
American Sleep Labs.
Michelle Jackson
Posted on February 27, 2020Hi Reggie. I saw that you offered to do the sleep study for free if this person on this blog could get to Houston. I am having similar issues. I was diagnosed with sleep apnea 16 years ago and got a cpap. A few years later I went for an MLST because I was still so tired all day and fell asleep EVERYWHERE. They diagnosed me with EDD and gabe me provigil. I don’t know why I stopped taking that medication as it was so long ago but now I am having serious consequences from my narcolepsy. My doctor refuses to give me the medication unless I get another sleep study but my insurance only covers 60%. I cannot afford the $1500ish copay for the sleep studies I have to get in order to get treated for my narcolepsy. I have found organizations that help pay for the cpap but I can’t find anything about help with the study itself. I saw your post and wondered if you might extend the same offer to me. I am in kc so houston isn’t that far and if I can find someone to make the drive with me (so I don’t fall asleep) would you be willing to help me with the MLST? I can probably pay some but not a large amount all at once. I’m able to make small monthly payments for services rendered if you are unable to provide it at no cost. I hope to hear back from you soon. Thank you.
Lacie Hornberger
Posted on November 05, 2020That is an awesome prayer that you answered Thanks for your help..
Angie Willis
Posted on March 22, 2019My dr scheduled a sleep test for me and I was told the cost will be $7000. This seemed really high so I called around and found a sleep center a few hours away that charges $690. I requested my dr send my orders to that center for the test and he said no because the elevation difference would skew my results. I will be searching for a sleep center closer to my elevation but I have a feeling the dr will reject that too. Is elevation that big a deal that I should have to pay 10x as much?
Dawn
Posted on April 06, 2019my husband tried to do his sleep study last night (8:30 pm) but had restless legs and could not sleep even with taking one ambien. He left at 1:30 am without ever sleeping. Do you think medicare cover this attempt at a sleep study? Would they cover an at home test where he may have more success sleeping?
Ramon Guerrero
Posted on April 15, 2019I’m from the Lubbock tx, area.. I’ have been with this sleep problem for years…I have been terminated from jobs and have hade near misses on the highway all the time..my last one a week ago fell asleep crashed into a light pole..helicopter flew me in thanks to our lord..I was saved..can’t offerd machine nor supplies and for the study..I have to pay bills feed family and now look for a vichical..to look for a new job..I’m desperate my family desarves better..I wish I could have my dream job and get my CDL..but just a dream..please help!!!
Lindsay Stallworth
Posted on April 23, 2019Need to find out information, on getting a sleep study for my husband with severe sleep apnea. He was admitted into hospital after visit to ER and when he was discharge the doctor said he needed to get a sleep study done. I have try to set up one but they want a doctor order and will not accept the discharge summary. We are paying out of pocket for the sleep study since my husband done not have insurance. My mother in law is helping us with some cash to pay. Why do I need a order if we do not have insurance.
Jose l Esquivel
Posted on July 04, 2019Where can I take a sleep apnea test,I dont have any problem,during my sleep,taking a dot fisical,the Dr.dicide that I have to take a test,base on my wigth.I just need a test to prove that Im ok.Im 5.8 wigth 232lbs
RandyReel
Posted on December 06, 2019I have no health insurance I need to see sleep specialist only sleep 3to 4 hours a night what my options I’m tired from not sleeping .
Cyrus Borazjani
Posted on April 17, 2020I want to make a complaint about my very expensive Virginia Hospital Center’s sleep study bill.
Can you believe it? $7’002.3 !!!!!
Who is responsible for this kind of complains?
Anna L Parker
Posted on September 10, 2020Birthday April 1955 I have United Health care member I’d 907859271-00 How much does it cost. Health plan(80840)911-87726-04. My psychiatrist Barbara Morgan sent the referral in. I called Wake Forest someone in billing (I think) never got back to about cost. How much is it?
Anna L Parker
Posted on September 10, 2020Barbara Morgan called in a referral I have Medicare and UnitedHealthcare memberID 907859271-00 how much would it cost.
Lacie
Posted on November 05, 2020How can anyone afford a needed sleep study when it cost you an arm and leg just to see a specialist,,
Its crazy how its cheaper for people without insurance then it is for people with insurance.. There is absolutely no way I can afford my bills plus work 40+ hours take care of kiddos, while trying to figure out how to come up with the money needed for the hospital sleep study and the specialist fee..
my sleeping disorder is horrible
i have no energy for my kids, all i want to do is sleep and when i do sleep i dont feel rested and makes me even more sleepy..
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Julie Grindstaff
Posted on November 02, 2021I have no idea how people can afford these studies. I am a teacher in NC and with my insurance (which is pretty good) the cost will still be almost $3000! There is just no way. It is amazing that even DR required studies are that expensive.
Joey Janolo
Posted on December 16, 2021I too am skeptical of my professional bill I got recently on my sleep apnea study. I thought the machine was included and ended up paying for it exclusively. I’m just kinda confused how they come up with the professional bill higher than my doctor.When all the Nurse on the sleep clinic was just using phone calls to check on me yet most of the time it’s hard to contact them. I feel short changed with this service.
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Posted on February 22, 2022Deductibles for many people might range from $2,000 to $4,000 or more. So, while you have coverage for the procedure, you must pay for it out of cash until your deductible is met.
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