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Pennsylvania rates for HCPCS 95810

Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, attended by a technologist

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$121.75 / $127.83 / $222.80
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$568.95 / $720.28 / $1,309.27
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$112.06 / $144.08 / $494.45
Aetna
Facility/Professional
Professional
Modifier
52
Low / Median / High Price
$274.11 / $304.37 / $436.24
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$451.82 / $557.16 / $913.09
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$538.78 / $538.78 / $607.23
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$113.25 / $178.97 / $219.90
AmeriHealth
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$121.49 / $121.49 / $145.57
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$638.29 / $929.11 / $1,741.97
Capital Blue Cross
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$123.14 / $188.84 / $412.58
Capital Blue Cross
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$515.16 / $739.46 / $1,329.35
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$133.97 / $133.97 / $133.97
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$583.71 / $838.66 / $1,388.15
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$112.46 / $172.29 / $282.99
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$459.96 / $675.79 / $1,129.35
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$652.26 / $951.84 / $1,258.27
Emblem Health
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$130.18 / $167.76 / $238.87
Emblem Health
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$539.20 / $784.49 / $1,019.40
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$136.93 / $658.31 / $854.40
Highmark BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$129.08 / $161.63 / $201.47
Highmark BCBS
Facility/Professional
Professional
Modifier
52
Low / Median / High Price
$127.00 / $127.00 / $127.00
Highmark BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$532.65 / $567.29 / $571.22
Independence Blue Cross
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$121.49 / $121.49 / $247.80
Martin's Point
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$121.75 / $166.02 / $246.01
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$606.52 / $770.15 / $1,755.07
Martin's Point
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$116.67 / $176.06 / $473.68
Martin's Point
Facility/Professional
Professional
Modifier
52
Low / Median / High Price
$273.83 / $306.30 / $606.03
Martin's Point
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$484.77 / $645.35 / $1,673.75
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.08 / $810.50 / $1,224.39
Priority Health
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$133.97 / $133.97 / $133.97
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$583.71 / $838.66 / $1,400.91
Priority Health
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$112.23 / $167.81 / $288.64
Priority Health
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$462.27 / $675.79 / $1,138.08
UPMC Health Plan
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$115.29 / $115.29 / $199.50
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$569.61 / $579.29 / $630.26
UPMC Health Plan
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$112.49 / $115.29 / $119.39
UPMC Health Plan
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$454.40 / $464.01 / $510.87
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$568.32 / $718.02 / $1,157.65
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$109.35 / $151.32 / $243.62
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$442.13 / $594.40 / $969.34