How Much Does Sleep Apnea Surgery Cost

Obstructive sleep apnea (OSA), also simply called sleep apnea, is a common sleep disorder. People with OSA have abnormal breathing patterns - including short periods of not breathing, or apnea - during sleep. But the condition can also have a significant impact on your life when you're awake by leading to excessive daytime tiredness and an increased risk for developing heart disease.

The most common OSA treatment is positive pressure with a continuous positive airway pressure (CPAP) machine. But there are other ways to address the condition, including using oral devices and making lifestyle changes. If those techniques don't work, sleep apnea surgery may be an option for some people.

How much does sleep apnea surgery cost?

Without insurance, the average cost of sleep apnea surgery ranges from less than $10,000 for common nasal and throat surgeries to more than $100,000 for more complicated procedures, according to CareCredit, a medical credit card company.

Here are sample prices for popular OSA surgical treatments:

• Turbinate reduction surgery: Without insurance, the average price for this procedure is more than $4,700 nationwide, according to MDsave, a price-shopping tool for uninsured people and people with high-deductible health plans. If you also need septoplasty, expect to spend $3,500 to $11,000 or more.

• Uvulopalatopharyngoplasty: Known as UPPP, this surgery can cost $2,000 to $10,000 or more without insurance.

• Inspire implant: Without insurance, the price of an Inspire implant - the FDA-approved hypoglossal nerve stimulator - ranges from $30,000 to $40,000.

• Maxillomandibular advancement: This major surgery, known as MMA, can cost $80,000 to $100,000 without insurance.

It's important to note that the cost of these procedures also can vary depending on whether you have a bundled price or charges for each associated service. If you have a separate charge for anesthesia, for instance, that could raise the cost. Where you have the surgery can affect your bottom line, too: Going to an outpatient surgery center or having an in-office procedure is often less costly than having the procedure done at a hospital.

MDsave lists national and regional price ranges for a turbinate resection with septoplasty. Without insurance, the national average for this procedure was nearly $16,000 at the time of publication.

Here are some regional averages for a turbinate resection with septoplasty purchased through MDsave (redeemable at participating providers) at the time of publication:

• Houston: $8,213

• Indianapolis: $8,200

• Kansas City, Missouri: $7,328

• Las Vegas: $7,389

• Orlando, Florida: $8,761

• Phoenix: $7,972

What are the types of sleep apnea surgery?

There are multiple types of surgery that can address sleep apnea, including:

• Nasal:Nasal surgeries that treat OSA include turbinate reduction surgery, nasal valve surgery, septoplasty, and rhinoplasty.

• Upper throat: Sometimes, tonsil or adenoid removal is an option, as is a procedure to remove excess tissue and widen the airway called UPPP.

• Upper airway stimulation:Hypoglossal nerve stimulation involves a surgical implant. As of this publication, the only FDA-approved implant is the Inspire device.

• Tongue and lower throat: A lower throat treatment, such as tongue base reduction surgery, is sometimes used to address OSA.

• Maxillomandibular advancement: MMA is major facial and oral surgery that moves the bones of the upper jaw and lower jaw forward to treat OSA.

What causes sleep apnea?

There are many reasons why someone might have sleep apnea. The condition can be caused by physical features, such as jaw shape or neck size, and other factors, like body size.

Some people are at higher risk for developing sleep apnea than others. Risk factors that increase the likelihood of having OSA include:

• Male sex

• Older age

• Larger body shape and size

• Certain medications

• Certain medical conditions

• Genetic predisposal

Does insurance cover sleep apnea surgery?

Yes, insurance plans typically cover sleep apnea surgery, but your recommended procedure may only qualify for coverage under certain circumstances. And you could still have significant out-of-pocket expenses for your share of the bills. Check with your health plan to determine your specific benefits.

For instance, if you have original Medicare, UPPP and MMA are covered only under certain circumstances. And the Inspire implant is covered only if you meet a list of eligibility requirements. Coverage of UPPP, MMA, and the Inspire implant under Medicare Advantage plans meet or exceed original Medicare's benefits.

Most major private insurance plans cover the Inspire device for people who have not had success with a CPAP machine. The implant is also available at select U.S. Department of Veterans Affairs (VA) hospitals, as well as certain military hospitals and clinics.

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