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California rates for HCPCS 42975

Drug-induced sleep endoscopy, with dynamic evaluation of velum, pharynx, tongue base, and larynx for evaluation of sleep-disordered breathing, flexible, diagnostic

Facilitymedian $4,786 · 10th–90th $1,622$13,4900%10%10th90th$4,786Professionalmedian $135 · 10th–90th $98$4270%10%10th90th$135$50.0$200.0$1.0K$5.0K$20.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,290.87 / $6,456.54 / $16,218.10
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $131.83 / $436.52
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,570.40 / $4,570.88 / $12,882.50
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $165.96 / $354.81
Blue Shield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$85.11 / $1,000.00 / $2,089.30
Blue Shield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $165.96 / $331.13
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,000.00 / $1,000.00 / $1,174.90
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $151.36 / $331.13
Contra Costa Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $97.72 / $144.54
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $104.71 / $281.84
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $56.23 / $4,786.30
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$707.95 / $812.83 / $812.83
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $141.25 / $141.25
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$97.72 / $114.82 / $208.93
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $147.91 / $302.00
The Alliance
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $104.71 / $165.96
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$575.44 / $1,698.24 / $6,456.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $138.04 / $316.23