G0400

Home sleep test (hst) with type iv portable monitor, unattended; minimum of 3 channels

Medicare pricing data for 337 providers across 31 states

🤖AI Overview

Prices vary significantly by location — from $39 in Nebraska to $238 in Rhode Island. 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

Home sleep test (hst) with type iv portable monitor, unattended; minimum of 3 channels (HCPCS code G0400) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $149.49, but hospitals typically charge $384.91 — a 2.6x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$29.90

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $149.49, your out-of-pocket cost would be approximately $29.90. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$149.49
Average Hospital Charge
$384.91
Markup Ratio
2.6x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$384.91
Medicare Allowed$149.49
Medicare Payment$116.34

Hospitals charge 2.6x more than what Medicare allows for this procedure. Medicare actually pays $116.34 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Rhode Island$238$450133+59.1%
Illinois$216$254106,785+44.4%
Minnesota$186$1,15541397+24.4%
Wisconsin$177$650168+18.5%
Massachusetts$177$465336+18.3%
Ohio$162$6418184+8.3%
Maine$117$1546133-21.5%
Georgia$109$4196202-27.0%
New Jersey$100$476327-33.0%
South Carolina$99$760164-33.7%
California$97$64817540-35.2%
Florida$86$1,31910231-42.7%
Arizona$86$86220364-42.8%
Kentucky$84$326283-44.1%
Iowa$82$4952153-45.1%
New Hampshire$80$925312-46.6%
New York$80$546221,162-46.7%
Nevada$72$4403174-52.0%
Texas$67$27821558-55.3%
Missouri$65$19214180-56.7%
North Carolina$58$30313168-61.3%
Washington$58$45030434-61.3%
Michigan$48$79919191-67.8%
Pennsylvania$47$19317468-68.6%
Indiana$44$15814443-70.5%
Virginia$44$128462-70.7%
Kansas$43$450132-71.3%
North Dakota$43$16716212-71.5%
Oregon$41$224186-72.8%
Idaho$39$86549-73.9%
Nebraska$39$111117-74.0%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

Related from TheDataProject.ai

💊 Need post-procedure medications? Check costs on OpenPrescriber