Hello -
If you choose to rate this answer, please ask for any additional
information or clarification beforehand. Thanks for your
understanding.
I gathered rate information from 2 treatment centers, as noted below.
St. Luke's Hospital in Kentucky
http://www.health-alliance.com/hospitals/sle/stlukeeast_departments_sleep_center.html
The "raw" fees for sleep apnea treatment are as follows:
$208 for initial consultation
$77 for follow-up
These are handled as a typical co-pay arrangement with the insurance
company.
$1600 to $1800 for sleep studies
polysomongram (PSG) for the 1st study
CPAP titration for second
[paraphrased]: "Even though these are overnight, they are treated as
outpatient services to the insurance companies; most have one sleep
study, but some have two. Coverage typically ranges from 70% to 100%
depending on on things like which insurance company is used, insurance
plan selected, and the state one lives in."
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Cooper Health Family Sleep Center
http://www.cooperhealth.org/medical/condition/sleep.htm
$240 for consultation (co-pay)
$2000 for polysomnogram (PSG) (outpatient)
~$1800 for CPAP titration (outpatient)
$85 follow-up (co-pay)
"We have found most [insurance companies] 100% for our patients.
Co-pay can be $0 - $35."
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The universal CPT and ICD codes are as follows:
CPT for study 1 = 95810 (polysomnogram)
CPT for the second part = 95805 (quoted only by Cooper Health)
CPT for study 2 = 95811 (CPAP Titration, which is a second study)
ICD-9 code = 780.53
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I verified through Blue Cross of New York that, depending the policy,
coverage through an employer ranges from 80% all the way to 100%.
Co-pay doesn't normally go over $20.
Search strategy:
sleep apnea treatment
Blue Cross of Central New York: 800-633-6066 |
Request for Answer Clarification by
crystal4290-ga
on
03 Nov 2003 13:08 PST
This is VERY good, and I will happily pay for the answer. If I paid
an additional $40, could you get me information from three more
centers? Maybe one in Florida, and California, or Washington, or
Wisconsin. How about $15/center? Am I allowed to make a statement
like that? Or should I just offer a tip to you, for the additional
information? Sorry to be figuring this out.
Thanks again for your great work!!
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Clarification of Answer by
jbf777-ga
on
03 Nov 2003 14:27 PST
Hi crystal4290 -
You can certainly make a statement like that. :)
I have gathered data for 4 more centers in all 4 states, plus partial
data from 2 other centers in WA. You can simply add a tip of $40 to
this question, and I will gladly post the information.
Thanks,
jbf777
|
Clarification of Answer by
jbf777-ga
on
05 Nov 2003 08:27 PST
Thank you! Here is the additional information:
Sleep-Wake Disorders of South Florida
http://www.sleepwakesfl.com/privacy2.html
Polysomnogram and CPAP titration w/ consultation and follow-up:
$1850 w/ insurance
$2150 without insurance
They try to do it all in one evening. A separate follow-up CPAP
titration w/o insurance is $700.
---
High Desert Sleep Disorder Center (Apple Valley, CA)
Phone: 760-242-1886
Polysomnogram
$1700 or $1800
CPAP titration
$1800
Consultation: $150-$250
Follow-up: $60-$75
---
Marshfield Clinic Sleep Disorders Center (Marshfield, WI)
www.marshfieldclinic.com
Chippewa Falls Center
Polysomnogram
$2628
Polysomnogram and CPAP titration
$3115
Estimate on consultation: $300
---
Richland Sleep Disorders Center (Richland, WA)
Web Site: www.richsleep.com
509-946-4631
Polysomnogram
$1920
CPAP titration
$2070
Consultation: $271
Follow-up: estimate - $79 or $122
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PARTIAL DATA:
Sleep Center at Valley
Renton, WA
Polysomnogram
Estimate: $2100
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Sleep Disorders Center for Southwest Washington
Providence St. Peter Hospital
Polysomnogram
$2310.02
Poly and CPAP
$2658.83
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