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Ohio 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 $3,388 · 10th–90th $263$8,9130%10%10th90th$3,388Professionalmedian $132 · 10th–90th $95$6920%20%10th90th$132$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
$190.55 / $3,467.37 / $8,912.51
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $131.83 / $2,238.72
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $89.13 / $109.65
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,000.00 / $2,884.03 / $7,943.28
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $123.03 / $208.93
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$91.20 / $97.72 / $109.65
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$21,379.62 / $21,379.62 / $21,379.62
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $154.88 / $302.00
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$630.96 / $1,949.84 / $6,025.60
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $162.18 / $295.12
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $33.11
SummaCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $2,187.76
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $104.71 / $190.55
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$489.78 / $1,380.38 / $4,265.80
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $138.04 / $218.78