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Pennsylvania 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
Facility
Modifier
26
Low / Median / High Price
$17.75 / $19.64 / $58.36
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.02 / $68.81 / $88.16
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.88 / $67.33 / $140.15
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
$65.51 / $87.44 / $147.22
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.29 / $101.44 / $133.54
Martin's Point
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$19.64 / $58.36 / $58.36
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$62.10 / $75.06 / $182.02
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.57 / $87.80 / $178.70
Priority Health
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$20.92 / $20.92 / $20.92
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.63 / $86.60 / $147.72
UPMC Health Plan
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$17.96 / $17.96 / $22.00
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$62.59 / $63.47 / $75.50
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$59.14 / $74.59 / $130.30