G0399

Home sleep test (hst) with type iii portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ecg/heart rate and 1 oxygen saturation

Medicare pricing data for 2,818 providers across 52 states

🤖AI Overview

This procedure has a 6.7x markup — hospitals charge $471.54 but Medicare allows only $70.34. Uninsured patients may face bills 6.7 times higher than what insurance negotiates. Prices vary significantly by location — from $43 in South Dakota to $99 in District of Columbia. 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 iii portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ecg/heart rate and 1 oxygen saturation (HCPCS code G0399) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $70.34, but hospitals typically charge $471.54 — a 6.7x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$14.07

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $70.34, your out-of-pocket cost would be approximately $14.07. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$70.34
Average Hospital Charge
$471.54
Markup Ratio
6.7x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$471.54
Medicare Allowed$70.34
Medicare Payment$52.18

Hospitals charge 6.7x more than what Medicare allows for this procedure. Medicare actually pays $52.18 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
District of Columbia$99$4765178+40.6%
West Virginia$93$9904103+32.5%
Nevada$93$85418849+31.9%
Hawaii$89$4144316+26.3%
Puerto Rico$88$150129+25.6%
Delaware$88$74211234+25.4%
Ohio$87$391891,519+23.4%
California$87$82517310,229+23.2%
New Mexico$84$317566+20.0%
Maryland$83$43825893+18.7%
Kentucky$83$352592,521+18.6%
Alabama$83$40313656+18.5%
Utah$83$35826503+17.4%
Arizona$81$2862113,358+14.6%
Wyoming$78$4004111+10.8%
Florida$77$4012178,842+9.4%
New Jersey$77$438501,867+9.3%
Massachusetts$77$681702,617+9.1%
Georgia$76$3151201,149+8.2%
Nebraska$76$293211,096+7.5%
Oregon$74$351551,531+4.6%
Colorado$73$29721587+3.8%
Texas$73$6861252,144+3.3%
Mississippi$72$307650+2.5%
Vermont$72$4984118+2.0%
Virginia$71$29938889+1.3%
Alaska$70$1,1006319+0.2%
Rhode Island$70$326738-0.4%
South Carolina$70$393371,593-1.0%
Washington$67$3811143,644-4.4%
Montana$67$2527186-5.1%
North Carolina$66$693671,618-5.9%
Michigan$64$3431092,253-9.6%
New York$62$4111162,124-11.5%
Pennsylvania$61$4122044,396-13.2%
Tennessee$60$30632484-14.3%
Oklahoma$59$5507106-16.5%
Minnesota$58$40791618-17.9%
Louisiana$58$40229956-18.2%
Kansas$58$480211,159-18.2%
Illinois$56$3571973,543-20.5%
Indiana$56$381801,865-20.5%
Maine$55$4034361-22.3%
Iowa$54$287141,052-22.6%
Arkansas$49$4581167-29.8%
Connecticut$49$26133494-30.4%
North Dakota$48$2249101-31.9%
Wisconsin$48$633932,689-32.4%
Missouri$47$336741,538-33.9%
New Hampshire$45$419261,026-36.0%
Idaho$45$175231,150-36.7%
South Dakota$43$111221,252-38.4%

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

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💊 Need post-procedure medications? Check costs on OpenPrescriber