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Utah 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
$21.81 / $21.81 / $21.81
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.95 / $82.03 / $94.62
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.52 / $97.19 / $122.13
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.23 / $44.05 / $67.28
Regence BlueShield
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$203.75 / $203.75 / $203.75
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$76.09 / $100.00 / $171.62
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$62.93 / $85.50 / $120.48