Sleep study in sleep lab with continuous airway pressure (6 years or older)
Medicare pricing data for 6,329 providers across 52 states
Prices vary significantly by location — from $121 in New Hampshire to $550 in Nevada. 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 in sleep lab with continuous airway pressure (6 years or older) (HCPCS code 95811) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $310.03, but hospitals typically charge $1,235 — a 4.0x 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 $310.03, your out-of-pocket cost would be approximately $62.01. 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 4.0x more than what Medicare allows for this procedure. Medicare actually pays $241.49 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Nevada | $550 | $1,850 | 59 | 2,801 | +77.4% |
| California | $532 | $2,072 | 382 | 16,757 | +71.7% |
| Puerto Rico | $510 | $529 | 18 | 338 | +64.6% |
| Alaska | $509 | $3,609 | 20 | 647 | +64.2% |
| District of Columbia | $476 | $1,175 | 15 | 456 | +53.6% |
| Maryland | $461 | $1,523 | 116 | 3,933 | +48.8% |
| Wyoming | $449 | $1,563 | 5 | 213 | +45.0% |
| Delaware | $449 | $2,095 | 29 | 847 | +44.8% |
| Arizona | $447 | $1,731 | 107 | 5,355 | +44.1% |
| Florida | $416 | $1,384 | 450 | 14,356 | +34.0% |
| Hawaii | $395 | $1,237 | 17 | 592 | +27.4% |
| Rhode Island | $387 | $1,316 | 18 | 271 | +24.8% |
| Virginia | $380 | $1,171 | 172 | 6,049 | +22.7% |
| New York | $374 | $1,882 | 310 | 6,295 | +20.5% |
| Oregon | $370 | $1,191 | 75 | 2,813 | +19.2% |
| Texas | $321 | $1,313 | 443 | 16,168 | +3.4% |
| Montana | $320 | $891 | 27 | 1,444 | +3.4% |
| North Carolina | $318 | $1,224 | 267 | 6,303 | +2.7% |
| Georgia | $311 | $1,241 | 183 | 4,067 | +0.2% |
| New Mexico | $295 | $1,293 | 29 | 1,731 | -4.7% |
| New Jersey | $294 | $1,763 | 197 | 3,532 | -5.2% |
| South Carolina | $292 | $1,159 | 117 | 4,633 | -5.7% |
| Tennessee | $286 | $1,215 | 156 | 6,009 | -7.7% |
| Washington | $281 | $973 | 127 | 3,887 | -9.4% |
| Utah | $276 | $771 | 51 | 2,943 | -10.9% |
| Michigan | $269 | $758 | 255 | 6,099 | -13.3% |
| Illinois | $266 | $1,446 | 319 | 9,635 | -14.3% |
| Minnesota | $260 | $1,238 | 128 | 2,497 | -16.1% |
| Mississippi | $260 | $1,565 | 62 | 3,162 | -16.1% |
| Colorado | $255 | $759 | 101 | 4,608 | -17.7% |
| Connecticut | $252 | $1,354 | 68 | 1,305 | -18.7% |
| Massachusetts | $249 | $911 | 150 | 3,514 | -19.8% |
| West Virginia | $247 | $1,050 | 63 | 1,392 | -20.3% |
| Louisiana | $237 | $1,063 | 78 | 2,731 | -23.4% |
| Iowa | $230 | $912 | 47 | 3,142 | -25.7% |
| Alabama | $229 | $650 | 109 | 4,534 | -26.2% |
| Kansas | $223 | $935 | 50 | 2,183 | -28.2% |
| Pennsylvania | $212 | $767 | 303 | 6,981 | -31.8% |
| Ohio | $198 | $980 | 321 | 7,893 | -36.1% |
| North Dakota | $191 | $627 | 18 | 1,190 | -38.3% |
| Arkansas | $188 | $740 | 46 | 2,800 | -39.3% |
| Missouri | $180 | $804 | 182 | 5,019 | -42.0% |
| Vermont | $179 | $1,573 | 7 | 254 | -42.3% |
| Idaho | $178 | $495 | 42 | 1,216 | -42.5% |
| Kentucky | $169 | $825 | 104 | 2,748 | -45.5% |
| Oklahoma | $168 | $482 | 63 | 4,396 | -45.7% |
| Maine | $168 | $550 | 30 | 664 | -45.9% |
| Indiana | $168 | $758 | 153 | 4,752 | -45.9% |
| Nebraska | $158 | $492 | 40 | 1,775 | -49.1% |
| Wisconsin | $156 | $1,613 | 143 | 3,237 | -49.7% |
| South Dakota | $126 | $472 | 23 | 1,269 | -59.3% |
| New Hampshire | $121 | $752 | 29 | 941 | -60.9% |
⚠️ 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