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Sleep Airway Exam Under Light Sedation

Washington, DC rates for HCPCS 42975

This procedure examines the throat and airway using a thin scope while a patient is under light sedation that mimics natural sleep, to observe where and how the airway narrows or collapses. It's used to help pinpoint the source of snoring or sleep apnea before deciding on treatment, such as surgery or an oral device. The exam is done in real time as the sedation takes effect.

Rates data updated October 2026.

How much does Sleep Airway Exam Under Light Sedation cost?

$120

Typical physician fee. In Washington, DC, October 2026.

Insurers have agreed to pay about $120 for this service. Most negotiated rates run $110 to $275.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 5 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $550 · 10th to 90th $112 to $4,266Professionalmedian $112 · 10th to 90th $100 to $295
$100$200$500$1K$2K$5Kfacility $550professional $112

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$112.20
Median
$2,137.96
Typical High
$4,786.30
Aetna
Setting
Professional
Modifier
None
Typical Low
$109.65
Median
$112.20
Typical High
$281.84
CareFirst
Setting
Professional
Modifier
None
Typical Low
$100.00
Median
$109.65
Typical High
$645.65
Cigna
Setting
Professional
Modifier
None
Typical Low
$102.33
Median
$138.04
Typical High
$257.04
Kaiser Permanente
Setting
Professional
Modifier
None
Typical Low
$87.10
Median
$91.20
Typical High
$218.78
United
Setting
Facility
Modifier
None
Typical Low
$109.65
Median
$549.54
Typical High
$1,548.82
United
Setting
Professional
Modifier
None
Typical Low
$107.15
Median
$151.36
Typical High
$275.42

Where Washington, DC sits

The same service costs 7.6 times more in Oklahoma than in Kentucky. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Washington, DC· 44th of 51

$120

OK $724KY $95.50

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.