go back

Maine rates for HCPCS 94453

High altitude simulation test (HAST), with interpretation and report by a physician or other qualified health care professional; with supplemental oxygen titration

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$73.89 / $75.20 / $88.16
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.53 / $89.98 / $137.88
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$20.92 / $20.92 / $20.92
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.84 / $104.86 / $164.69
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$74.43 / $95.86 / $179.85
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$73.89 / $79.65 / $97.92
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.70 / $108.32 / $140.93