Sleep Airway Exam Under Light Sedation

Vermont 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?

$2,028

Typical total for the visit. In Vermont, October 2026.

Insurers have agreed to pay about $2,028 for this procedure. That total is two separate charges: $166 to the doctor who performs it, and $1,862 to the hospital or surgery center where it takes place. Done somewhere without a facility charge, you pay only the first.

8% physician fee92% facility fee

Few insurers publish rates for this combination, so treat this figure as a rough guide.

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 3 insurance carriers under federal price transparency rules.

What's inside this number

Part of the bill	Who charges it	Typical	Range
Physician feeThe doctor who performs it	The doctor who performs it	$166	$158 to $195
Facility feeThe hospital or surgery center	The hospital or surgery center	$1,862	$1,862 to $1,862

How much rates vary

Facilitymedian $1,862 · 10th to 90th $501 to $1,862Professionalmedian $166 · 10th to 90th $126 to $245

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	Facility/Professional	Modifier	Typical Low	Median	Typical High
Aetna Setting Facility Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09	Facility	None	$1,862.09	$1,862.09	$1,862.09
Aetna Setting Professional Modifier None Typical Low $117.49 Median $125.89 Typical High $125.89	Professional	None	$117.49	$125.89	$125.89
Cigna Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $1,862.09	Facility	None	$467.74	$467.74	$1,862.09
Cigna Setting Professional Modifier None Typical Low $158.49 Median $165.96 Typical High $257.04	Professional	None	$158.49	$165.96	$257.04
United Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19	Facility	None	$501.19	$501.19	$501.19
United Setting Professional Modifier None Typical Low $128.82 Median $165.96 Typical High $245.47	Professional	None	$128.82	$165.96	$245.47

Where Vermont 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

Vermont· 10th of 51

$2,028

$166 physician + $1,862 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.