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New Jersey 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 $5,495 · 10th–90th $1,950–$8,5110%20%10th90th$5,495Professionalmedian $120 · 10th–90th $91–$2,5120%20%10th90th$120$1.0$5.0$20.0$100.0$500.0$2.0K$10.0K

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
$1,949.84 / $5,623.41 / $8,511.38
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $117.49 / $2,691.53
AmeriHealth
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$741.31 / $1,621.81 / $8,317.64
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $177.83 / $457.09
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $120.23 / $158.49
Horizon BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,630.78 / $5,495.41 / $8,709.64
Horizon BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $125.89 / $269.15
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,348.96 / $2,691.53 / $6,606.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $120.23 / $251.19