Sleep & PAP DME reimbursement rates by service line
Compare payer-published sleep & PAP DME benchmarks for PAP devices; masks and interfaces; tubing and filters; humidification; oral appliances.
Compare national sleep & PAP DME rates by payer
Use the reference codes to compare payer benchmarks, then explore PAP devices; masks and interfaces; tubing and filters; humidification; oral appliances. Each rate represents a specific billing code and comparison cohort, rather than a complete episode of care.
Aetna state variation for E0601
National E0601 rate distribution
Each marker shows the national median published rate across billing entities for that payer.
National E0601 rates by payer
| Payer | Rate period | Provider entities | P25 | Median | P75 | P90 | Average |
|---|---|---|---|---|---|---|---|
| Aetna | Jun–Jul 2026 | 1,323 | $42.73 | $52.74 | |||
| Cigna | Jun–Jul 2026 | 7,493 | $65.83 | $69.06 | |||
| United | Jun–Jul 2026 | 9,056 | $43.89 | $48.62 | |||
| Anthem | Jun–Jul 2026 | 5,514 | $40.10 | $45.12 |
- Source
- Negotiated or fee-schedule amounts published directly by payers in their machine-readable files.
- Rate shown
- Published commercial rate for continuous positive airway pressure (CPAP) device (E0601).
- Method
- Eligible rates are grouped by payer and billing entity so the benchmarks use a consistent service and billing basis.
The state map uses one consistent Aetna reference series; it does not average already-aggregated payer values. The service-line table keeps unlike codes, settings, and billing units in separate comparisons.
How do specific sleep & PAP DME providers compare?
Compare named provider rates with the selected payer's median and percentile distribution.
National: Sleep & PAP DME provider benchmarks (HCPCS E0601)
| Provider entity | State | Size | $ per reported rental amount | Gap to median | Position in Aetna range |
|---|---|---|---|---|---|
| KENTUCKY INSTITUTE FOR EYE, HEALTH, AND SURGERY, P.S.C.NPI 1013015510 · Tax ID 610719599 | KY | 64 | $31 | -$11.73 | Below P25 |
| DASCO HOME MEDICAL EQUIPMENT, INC.NPI 1144466467 · Tax ID 311441519 | OH | 28 | $42.72 | -$0.01 | P25 to median |
| OKULEYS PHARMACY AND HOME MEDICAL INCNPI 1619958592 · Tax ID 341897040 | OH | 1 | $42.72 | -$0.01 | P25 to median |
| ADVANCED SLEEP CENTER INCNPI 1184775074 · Tax ID 202234168 | LA | 1 | $42.73 | +$0 | Median to P75 |
| ADVANCED HOME MEDICAL INCNPI 1831287150 · Tax ID 030526966 | KY | 1 | Above P75 | ||
| ASSOCIATED PODIATRY GROUP OF SAN CARLOSNPI 1932290178 · Tax ID 941388702 | CA | 4 | Above P75 |
Choose one state to replace the mixed-state examples with payer-specific provider rates across all three preview codes.
No trial or data preparation required.Explore sleep & PAP DME services
Compare codes within the same billing context. A reported billing unit may describe a timed service, supply quantity, daily service or procedure; it does not always mean one visit.
| Service line / billing code | Aetna | Cigna | United | Anthem |
|---|---|---|---|---|
$ per reported supply amount · 10 codes | ||||
A7030Full face mask used with positive airway pressure device | $84.39 | $94.75 | $91.99 | $94.72 |
A7031Face mask interface | $34.70 | $38.67 | $34.02 | $35.72 |
A7032Cushion for use on nasal mask interface | $17.97 | $20.13 | $19.81 | $20.02 |
A7034Nasal interface (mask or cannula type) used with positive airway pressure device | $52.76 | $58.90 | $58.60 | $59.16 |
A4604Tubing with integrated heating element for use with positive airway pressure device | $32.94 | $37.53 | $36.37 | $40.67 |
A7033Pillow for use on nasal cannula type interface | $13.35 | $15.94 | $14.36 | $16.14 |
A7038Disposable filter for positive airway pressure device | $2.06 | $2.32 | $2.43 | $2.21 |
A7035Headgear used with positive airway pressure device | $17.23 | $20.24 | $19.54 | $19.47 |
A7046Water chamber for humidifier | $9.92 | $12.32 | $11.20 | $12.03 |
A7037Tubing used with positive airway pressure device | $15.62 | $15.40 | $16.80 | $13.38 |
$ per reported rental amount · 5 codes | ||||
E0601Continuous positive airway pressure (CPAP) device | $52.74 | $69.06 | $48.62 | $45.12 |
E0562Humidifier | $12.55 | $14.33 | $14.77 | $14.59 |
E0470Respiratory assist device | $125.09 | $122.34 | $117.82 | $114.14 |
E0471Respiratory assist device | $324.89 | $283.45 | $293.68 | $293.52 |
E0486Oral device/appliance used to reduce upper airway collapsibility | Not available | Not available | Not available | $99.32 |
Tell us the services, payers, states, and networks you need. We'll confirm available coverage and scope the comparison on a 20-minute call.
Book a 20-min scoping call No trial or data preparation required.How to interpret these benchmarks
Payer-published rates provide market context. They do not establish a practice's contracted rate or the total cost of care.
- Source and periodRates come from the specialty's national report. The displayed period follows the processed data included in the latest published snapshot and updates when that snapshot is refreshed.
- Comparable ratesComparisons use positive professional fee-for-service negotiated and fee-schedule dollar amounts. Percentages, bundled arrangements and per-diem rate types are excluded. Modifier cohorts and code-specific amounts remain separate.
- CalculationRates are reduced to one modal value per NPI and TIN entity, averaging tied modes. Two percent per tail is targeted for trimming while keeping boundary ties. Benchmarks require at least 10 included entities and are not weighted by patient volume.
- CoverageNational report coverage does not guarantee every payer or state is available for every code. Anthem represents the displayed Anthem cohort, rather than all regional Blue plans. Missing benchmarks are not zero rates.
- Billing contextMatch the exact code, billing unit, modifier, setting and network. Equipment rentals and supplies require their own interval and quantity checks. Professional rates exclude facility charges; anesthesia conversion factors are outside these comparisons.
Get the sleep & PAP DME reimbursement data you're looking for
Choose the services, payers, states, networks, and provider entities relevant to your question. We'll confirm the available coverage and prepare the comparison.
- Tell us your marketShare the specialty, geography, payers, networks, and providers.
- We find comparable ratesPayerPrice aligns billing codes, services, settings, and units.
- Get your market viewSee relevant payer and provider rates organized around your question.
We'll tell you what the data can support, where the gaps are, and the clearest way to structure the comparison.
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Explore sleep & pap dme rates by state
Choose a state to compare payer reference averages for common services.
Questions about sleep & PAP DME benchmarks
How to interpret the selected market and payer-published rates.
What does the national benchmark compare?
The headline uses Continuous positive airway pressure (CPAP) device (E0601). The other reference codes and service lines provide separate comparisons rather than combining unlike services.
Why is a payer or state missing?
A benchmark appears only when the selected code and cohort meet the publication rules, including at least 10 entities after trimming. Report-wide coverage can be broader than an individual comparison.
Will the reporting period change?
Yes. The period displayed with the benchmark follows the processed source data when the publication snapshot is refreshed.