How Much Do In-Center and Home Sleep Studies Cost to Assess Sleep?

Expenses Vary Based on Study Type, Insurance Coverage

An in-center sleep study called a polysomnogram is more comprehensive and costs more than home sleep apnea testing
An in-center sleep study called a polysomnogram is more comprehensive and costs more than home sleep apnea testing. Getty Images

Health care expenses can be a little intimidating. If your doctor has recommended that you undergo a sleep test to evaluate for a sleep disorder, you may wonder: How much do sleep studies cost? Is there a big difference between the cost of an in-center and home sleep apnea test? What testing is required to diagnose your sleep disorder? How much of the expenses do insurance cover? The answers may surprise you.

Types of Sleep Studies: In-Center vs. Home Sleep Apnea Testing

The most commonly used test to assess for conditions like sleep apnea is the polysomnogram (PSG). This test is typically performed at a sleep center or sleep lab. It may be called in-lab, in-center, or attended testing. It includes the placement of numerous wires to monitor your brain wave activity and sleep stages with an EEG, your heart rhythm with an EKG, muscle tone, leg movements, breathing patterns, and your blood's oxygen levels. These are placed by a sleep technician who then monitors the data acquisition overnight. If sleep apnea is observed, treatment may even be initiated with continuous positive airway pressure (CPAP) to find the appropriate pressure to improve your breathing.

The PSG may be used to identify other sleep disorders as well, including periodic limb movements of sleep (PLMS), narcolepsy, and sleep behaviors called parasomnias.

It is not used to assess insomnia if it is suspected to occur in isolation. If seizures are suspected, additional scalp electrodes may be used to enhance detection (sometimes called an extended EEG).

The major alternative to an in-center sleep test is home sleep apnea testing. There are a variety of devices that are used for this purpose.

In general, these devices do not record sleep stages, heart rhythms with EKG, or leg movements. They are most effectively used to diagnose sleep apnea alone as they measure breathing patterns, air flow, and oxygen levels well. As such, this evaluation is sometimes called home sleep apnea testing. They also record pulse rates and often sleep position. Patients are instructed on how to connect the monitors and then use it at home and take it back after the testing is complete.

How do these two categories of tests differ in cost?

Factors that Determine Sleep Study Cost

It is very difficult to obtain specific information about sleep study costs across institutions as this is not widely reported. With changes in the health care system, these data are becoming more accessible.

There can be great variability in what is charged for what amounts to the same service. This reimbursement may vary in part based on the availability of resources in a particular region. Sleep testing centers may be associated with a university or operate for-profit, with vastly different expenses charged for testing.

In medicine, there is also a difference between what an insurance company gets charged, and what they ultimately pay.

The ultimate cost is something that is negotiated between sleep centers and these insurers. Therefore, an uninsured patient who pays out of pocket (or cash) may get a different price, one that is often lower than what would initially be charged to an insurer.

Your ultimate costs will likely depend on your insurance type as well as specifics related to your annual deductible and other factors outlined in your policy.

What Does a Sleep Study Cost?

The overnight polysomnograms that are performed in a sleep center may cost from $600 to $5,000 for each night, according to various discussions online. The average is typically around $1000 per night.

Likely one of the most expensive places to get a sleep study is Stanford University, where studies are about $8,500 per night. Insurance may cover the majority of this expense.

Home sleep apnea testing is significantly less expensive, due to the fact that less data is collected and the overhead costs of maintaining a sleep center and paying a sleep technician do not exist. In general, these tests may cost closer to $200 to $600 per night. It is important to recognize that home testing may not be appropriate for everyone and if the home study fails to identify your sleep apnea after 3 nights of assessment, an in-center test may still be necessary. Home sleep apnea testing cannot identify other sleep disorders. Currently this testing is not appropriate for use in children.

How Much of the Expenses Does Insurance Cover?

The coverage of these study costs may vary depending on your insurance policy. It is an outpatient procedure. The specific billing codes can be disclosed by your medical provider. It is generally a covered benefit with many insurance policies, including Medicare.

Though it may be included in your benefits, there are some additional variables to consider. If it is early in the year, it may be necessary to meet your policy's minimum deductible. This means that the costs of medical care may not be covered until that minimum amount has been paid for the year. Once the deductible is met, a certain percentage of the cost of the testing (and other medical expenses) may be covered. Unfortunately, there are still some policies that exist that offer little or no coverage of the testing.

If you are concerned about the costs of your sleep evaluation, it is best to call ahead and get the information from the testing center or your insurance company prior to having the study. Any reputable sleep center, especially those associated with health care centers, should be able to provide you with an estimate of the expense prior to your evaluation. This is the best way to avoid any costly surprises.

A Word from Verywell

It can be intimidating to consider the costs of any medical care. The sticker shock may lead you to put off the procedure, especially when it is considered elective and not something that has to be done. Carefully consider the impacts of an untreated sleep disorder on your well-being and long-term health, as well as on relationships and productivity. When sleep is poor, everything seems to suffer. Consider your testing options carefully, express any concerns you have about the study costs with your board-certified sleep specialist, and place a high value on the benefits of a good night of sleep. The cost of a sleep study may be an investment, but one that is worth it in the long run.

Sources:

4 Steps to Correct Coding for Home Sleep Apnea Testing. Sleep Review.

Sleep Coding FAQ. American Academy of Sleep Medicine.

Continue Reading