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Sleep Airway Exam Under Light Sedation

Wisconsin 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.

Facilitymedian $4,169 · 10th–90th $331$7,0790%10%20%10th90th$4,169Professionalmedian $191 · 10th–90th $98$4270%10%10th90th$191$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
Setting
Facility
Modifier
Global
Typical Low
$0.95
Median
$4,073.80
Typical High
$7,762.47
Aetna
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$162.18
Typical High
$426.58
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$2,630.27
Median
$4,570.88
Typical High
$7,079.46
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$181.97
Typical High
$549.54
Cigna
Setting
Facility
Modifier
Global
Typical Low
$251.19
Median
$295.12
Typical High
$467.74
Cigna
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$354.81
Typical High
$407.38
DeanCare
Setting
Facility
Modifier
Global
Typical Low
$104.71
Median
$2,630.27
Typical High
$5,128.61
DeanCare
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$239.88
Typical High
$281.84
Medica
Setting
Facility
Modifier
Global
Typical Low
$112.20
Median
$1,445.44
Typical High
$3,235.94
Medica
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$213.80
Typical High
$602.56
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$70.79
Network Health
Setting
Facility
Modifier
Global
Typical Low
$831.76
Median
$933.25
Typical High
$2,344.23
Network Health
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$141.25
Typical High
$239.88
Quartz
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$218.78
Typical High
$302.00
Quartz
Setting
Facility
Modifier
Global
Typical Low
$3,019.95
Median
$3,019.95
Typical High
$4,466.84
Quartz
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$398.11
Typical High
$707.95
Security Health
Setting
Professional
Modifier
Global
Typical Low
$407.38
Median
$407.38
Typical High
$407.38
Security Health
Setting
Professional
Modifier
Global
Typical Low
$346.74
Median
$489.78
Typical High
$630.96
United
Setting
Facility
Modifier
Global
Typical Low
$1,023.29
Median
$1,659.59
Typical High
$3,630.78
United
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$190.55
Typical High
$512.86