Cost of Sleep Test/Study in your Area/Jurisdiction

Hi,

I'm not sure if this has been discussed before but here goes.

I'm just curious as to how much a sleep test/study costs in your area or jurisdiction. I've seen several individuals self-prescribing to themselves cpap machines without going through the test/study in an official sleep lab.

Here in our area/jurisdiction, a sleep test or study would set you back 300USD (when converted to USD) for the diagnostics and another 300USD for titration. If you have PhilHealth (the government insurance here, obviously not applicable to non-residents), it goes down to about 160-170USD per test. Back in 2010, during my first test or study, it wasn't covered yet by PhilHealth and the prices were still steep.

My HMO won't cover it since they claim that it's a special modality.

I was just thinking if the cost is the major reason why people don't go through this study or test, it might be an option to simply go to another jurisdiction and have it done there, get a vacation in the process, and still get some change to spare instead of having it in your area. Of course, there will be other considerations like covered by insurance, time off work, physically unable to travel and etc but, for those who dont have this limitations/restrictions:

1. What do you guys think?
2. Where is it cheapest to get this test/study?
3. Which areas charge the highest?

Just some thoughts.

Best,

Egzbuen


Sent from heaven

Planning on moving? I don't know I have ins, didn't get a bill, paid for it by working, that ruined my health. Jim

Due to the variety of ins, and billing and places it's dont, no valid answer is useful, it's playing solitaire with 51 cards.

Goofproof wrote:Planning on moving? I don't know I have ins, didn't get a bill, paid for it by working, that ruined my health. Jim

Due to the variety of ins, and billing and places it's dont, no valid answer is useful, it's playing solitaire with 51 cards.

Not for me. For those who self-prescribe machines to themselves for the sole reason they can't afford the test/study.

Sent from heaven

I'm in Australia. The public health system, Medicare, covers 100% of the cost of initial sleep studies and titration studies when conducted in the public hospital system. There was about a 3 month wait to have the first study and less than a month for the titration study. Follow-up appointments with a doctor were also included.

There is the choice to have it done privately too. I'm not sure how much that costs or whether private health insurance or extras cover pays for any or all of the cost. Certainly I could have had the studies done in a matter of days if I had chosen to go privately. If I had known what my API was, 58.9, I certainly would have considered going that way.

CPAP machines are also fully covered (API>30) for health care and concession card holders as well as veterans. I have to pay full price for mine.

The last time I was at Stanford, the non insurance cost was stated to be around $10k. I think insurance reimbursed them $800 or so.

cands wrote:I'm in Australia. The public health system, Medicare, covers 100% of the cost of initial sleep studies and titration studies when conducted in the public hospital system. There was about a 3 month wait to have the first study and less than a month for the titration study. Follow-up appointments with a doctor were also included.

There is the choice to have it done privately too. I'm not sure how much that costs or whether private health insurance or extras cover pays for any or all of the cost. Certainly I could have had the studies done in a matter of days if I had chosen to go privately. If I had known what my API was, 58.9, I certainly would have considered going that way.

CPAP machines are also fully covered (API>30) for health care and concession card holders as well as veterans. I have to pay full price for mine.

My brother is from Adelaide and a doctor there. He says medical insurance there covers almost everything.

That's great to hear.

Hmmm wrote:The last time I was at Stanford, the non insurance cost was stated to be around $10k. I think insurance reimbursed them $800 or so.

Oh my. How about the other sleep labs in CONUS, do they charge as much as Stanford?

Sent from heaven

cands wrote:I'm in Australia. The public health system, Medicare, covers 100% of the cost of initial sleep studies and titration studies when conducted in the public hospital system. There was about a 3 month wait to have the first study and less than a month for the titration study. Follow-up appointments with a doctor were also included.

There is the choice to have it done privately too. I'm not sure how much that costs or whether private health insurance or extras cover pays for any or all of the cost. Certainly I could have had the studies done in a matter of days if I had chosen to go privately. If I had known what my API was, 58.9, I certainly would have considered going that way.

CPAP machines are also fully covered (API>30) for health care and concession card holders as well as veterans. I have to pay full price for mine.

My GP got me into a bulk billed sleep clinic within two weeks. The titration study took about a month to come through so about 8 weeks in total. Nil cost - the Aussie medical system is pretty darn good. Yes, our taxes pay for it but considering that your health is the most important thing it's not a problem. I've also got top health cover but they didn't want to have anything to do with OSA.

egzbuen wrote:How about the other sleep labs in CONUS, do they charge as much as Stanford?

Not normally....Stanford is just real proud of being Stanford.

In the US it's common for the sleep labs to quote/bill an outlandish price initially but in reality they end up having to accept whatever the insurance says they should be happy with.
They often will have a "special" cash price for those without insurance.
God help the patient that has insurance but didn't verify that their insurance has a contract with that sleep lab and it ends up being an out of network expense.

My sleep study was around $2500 each (one diagnostic and second night titration). My sleep study was done in a hospital.
My insurance didn't pay anything near that billed amount. I want to say it paid around $800 for each but I don't remember exactly. I never got a bill for the difference which surprised me because I thought I would have to pay 20% of the allowed amount....but I didn't call them up to ask why I didn't get a bill.

Both of mine (2010, Nebraska). were under a grand each, mostly paid for by BCBS.
Insurance did not negotiate the cost, but I suspect Uncle Blue does a lot of business under the table.

I was re-titrated for an ASV three weeks ago. The sleep center billed $4300, and the insurance company agreed to a cost of just over $2400. I will have to pay a co-insurance of $240.

Holy buckets! $4300? Do you live in NYC? Or was it done at a hospital?

My sleep study and titration were about $800 each (2 different nights). Insurance covered it all.

Mine was a split night study done in a hospital. It was billed at almost $6400 and they got $4400. I had to pay over $800 of it.

My study seems to be one of the most expensive I have seen in the few years I have been here.. Had I known in advance, I probably would have declined, so I'm glad I didn't know. It turned out to be a really good sleep study for me. The facility was nice. The room was like a hotel room. The bed was a sleep comfort bed. I didn't even had to adjust it. They asked me if the temp of the room was good and increased it when I asked.

The tech was awesome. She helped me feel comfortable, and she picked the perfect mask for me. I requested the same mask when I got my machine, and while it took me a few weeks to master the fit, I knew it would work since it fit so well at the study. She had me use the mask and machine for about 10 minutes before going to bed so that it wouldn't be a complete shock if I qualified for a split night study. I woke up once about an hour and a half in, and I had to use the bathroom. I didn't know that this was common with sleep apnea. I was embarrassed and tried to go back to sleep since it would require the tech to come unhook me to go to the bathroom. She must see that a lot. She came into the room and said something about seeing I was awake and needing to adjust a wire. She was breaking the ice so I could go to the bathroom and go back to bed. Later, when she woke me to start the titration, she asked if I needed to use the restroom first (good idea). She then put the mask on me, and I rolled over and slept over 5 hours straight. I can't remember doing that for years and years before then. It was the best night of sleep ever. It was so good that the next night at home, I had a dream that I had to wait 6 months to get my cpap machine, and I was angry. I wanted it now. My asleep brain knew how good that night was and what caused it.

So, while it was expensive, it set me up for success. Good data. Perfect mask choice. And a successful night that gave me a taste of what cpap success would do for my life. I feel bad for people who are struggling with cpap and haven't had a taste of success. It has to be hard to keep trying and not know what the goal feels like. I still have bad nights sometimes, but even my bad nights now and better than my average nights before.