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New York 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 $4,169 · 10th–90th $178$8,9130%10%10th90th$4,169Professionalmedian $132 · 10th–90th $95$3310%20%10th90th$132$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
$158.49 / $4,073.80 / $8,912.51
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $131.83 / $331.13
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,630.27 / $4,786.30 / $9,772.37
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $114.82 / $288.40
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$158.49 / $158.49 / $158.49
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $158.49 / $158.49
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$34.67 / $3,235.94 / $53,703.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $229.09 / $549.54
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$97.72 / $131.83 / $323.59
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $120.23 / $173.78
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $123.03 / $204.17
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,238.72 / $3,388.44 / $6,456.54
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $114.82 / $114.82
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$138.04 / $50,118.72 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $173.78 / $398.11
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,348.96 / $2,511.89 / $4,897.79
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $147.91 / $338.84
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $117.49 / $158.49
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $117.49 / $204.17