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Sleep Airway Exam Under Light Sedation

South Dakota 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?

$355

Typical total for the visit. In South Dakota, October 2026.

Insurers have agreed to pay about $355 for this procedure. That total is two separate charges: $214 to the doctor who performs it, and $141 to the hospital or surgery center where it takes place. Done somewhere without a facility charge, you pay only the first.

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 7 insurance carriers under federal price transparency rules.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$214$158 to $257
Facility feeThe hospital or surgery center$141$126 to $1,148

How much rates vary

Facilitymedian $141 · 10th to 90th $126 to $5,129Professionalmedian $214 · 10th to 90th $102 to $316
$100$200$500$1K$2K$5Kfacility $141professional $214

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
$3,090.30
Median
$5,128.61
Typical High
$5,128.61
Aetna
Setting
Professional
Modifier
None
Typical Low
$81.28
Median
$93.33
Typical High
$131.83
Cigna
Setting
Facility
Modifier
None
Typical Low
$138.04
Median
$141.25
Typical High
$1,148.15
Cigna
Setting
Professional
Modifier
None
Typical Low
$199.53
Median
$251.19
Typical High
$281.84
Medica
Setting
Facility
Modifier
None
Typical Low
$125.89
Median
$138.04
Typical High
$812.83
Medica
Setting
Professional
Modifier
None
Typical Low
$125.89
Median
$257.04
Typical High
$316.23
Midlands
Setting
Professional
Modifier
None
Typical Low
$208.93
Median
$257.04
Typical High
$257.04
Midlands
Setting
Facility
Modifier
None
Typical Low
$138.04
Median
$1,148.15
Typical High
$1,348.96
Sanford Health Plan
Setting
Professional
Modifier
None
Typical Low
$134.90
Median
$165.96
Typical High
$190.55
United
Setting
Facility
Modifier
None
Typical Low
$125.89
Median
$125.89
Typical High
$223.87
United
Setting
Professional
Modifier
None
Typical Low
$125.89
Median
$281.84
Typical High
$316.23
Wellmark
Setting
Professional
Modifier
None
Typical Low
$186.21
Median
$213.80
Typical High
$213.80

Where South Dakota sits

The same service costs 14.5 times more in Colorado than in Michigan. 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.

Physician feeFacility fee

South Dakota· 45th of 51

$355

$214 physician + $141 facility

CO $3,953MI $273

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.