Sleep study including heart rate, breathing, airflow, and effort
Medicare pricing data for 4,506 providers across 51 states
This procedure has a 5.8x markup — hospitals charge $322.68 but Medicare allows only $55.85. Uninsured patients may face bills 5.8 times higher than what insurance negotiates. Prices vary significantly by location — from $41 in Arkansas to $89 in Puerto Rico. Where you get this procedure matters more than almost any other factor. Note: These costs reflect the Medicare physician/supplier component. Hospital facility fees are billed separately and can be 2-5x the physician fee.
💡 What You Should Know
Sleep study including heart rate, breathing, airflow, and effort (HCPCS code 95806) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $55.85, but hospitals typically charge $322.68 — a 5.8x markup. Prices vary significantly by state and provider.
🏷️ Typical Out-of-Pocket Cost
Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $55.85, your out-of-pocket cost would be approximately $11.17. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.
What Hospitals Charge vs. What Medicare Pays
Hospitals charge 5.8x more than what Medicare allows for this procedure. Medicare actually pays $41.64 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Puerto Rico | $89 | $141 | 3 | 45 | +59.7% |
| Nevada | $87 | $617 | 25 | 397 | +56.3% |
| District of Columbia | $82 | $234 | 4 | 105 | +46.5% |
| Maryland | $77 | $346 | 95 | 1,997 | +38.7% |
| California | $76 | $493 | 347 | 6,697 | +36.2% |
| Virginia | $71 | $411 | 117 | 2,623 | +27.3% |
| Georgia | $69 | $455 | 115 | 1,845 | +22.7% |
| Connecticut | $67 | $459 | 98 | 1,645 | +19.3% |
| Maine | $65 | $302 | 28 | 594 | +16.3% |
| Michigan | $64 | $253 | 186 | 2,583 | +15.3% |
| New York | $64 | $455 | 245 | 4,355 | +14.0% |
| Texas | $61 | $371 | 334 | 8,098 | +8.8% |
| Alaska | $61 | $490 | 20 | 222 | +8.5% |
| Hawaii | $60 | $304 | 10 | 100 | +7.4% |
| Colorado | $60 | $278 | 86 | 3,612 | +7.0% |
| Florida | $59 | $272 | 277 | 5,165 | +5.8% |
| Alabama | $58 | $349 | 68 | 1,080 | +4.0% |
| Delaware | $57 | $458 | 28 | 833 | +1.6% |
| Rhode Island | $56 | $178 | 14 | 401 | +0.8% |
| New Jersey | $55 | $438 | 166 | 3,972 | -1.9% |
| Kansas | $54 | $305 | 51 | 1,324 | -3.5% |
| Utah | $51 | $212 | 39 | 2,176 | -8.1% |
| Idaho | $51 | $282 | 26 | 197 | -8.4% |
| Massachusetts | $51 | $245 | 92 | 2,927 | -8.8% |
| North Carolina | $50 | $264 | 144 | 2,407 | -9.8% |
| Arizona | $50 | $269 | 55 | 1,410 | -9.9% |
| South Carolina | $50 | $228 | 95 | 2,185 | -10.8% |
| Tennessee | $50 | $351 | 145 | 2,931 | -11.4% |
| West Virginia | $49 | $257 | 60 | 848 | -12.3% |
| Illinois | $49 | $358 | 220 | 4,167 | -12.9% |
| Pennsylvania | $47 | $236 | 178 | 4,846 | -15.8% |
| Oklahoma | $47 | $187 | 51 | 1,413 | -16.0% |
| Washington | $47 | $215 | 72 | 1,299 | -16.2% |
| New Mexico | $46 | $321 | 24 | 613 | -17.1% |
| Oregon | $46 | $158 | 42 | 803 | -18.2% |
| Minnesota | $45 | $209 | 71 | 1,066 | -18.7% |
| Indiana | $45 | $191 | 124 | 2,095 | -18.9% |
| Ohio | $45 | $291 | 216 | 3,334 | -18.9% |
| Wisconsin | $45 | $509 | 94 | 1,705 | -19.1% |
| Montana | $45 | $222 | 17 | 354 | -19.4% |
| New Hampshire | $45 | $221 | 21 | 212 | -19.8% |
| Missouri | $45 | $222 | 117 | 2,369 | -20.1% |
| Louisiana | $45 | $248 | 52 | 668 | -20.1% |
| Mississippi | $45 | $298 | 46 | 866 | -20.2% |
| Iowa | $44 | $248 | 24 | 1,110 | -21.0% |
| Kentucky | $43 | $186 | 84 | 2,236 | -22.4% |
| North Dakota | $43 | $141 | 4 | 32 | -23.4% |
| Vermont | $43 | $238 | 5 | 65 | -23.8% |
| South Dakota | $42 | $105 | 12 | 84 | -24.0% |
| Nebraska | $42 | $167 | 37 | 1,532 | -25.6% |
| Arkansas | $41 | $180 | 15 | 611 | -26.9% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
💊 Need post-procedure medications? Check costs on OpenPrescriber