go back

California rates for HCPCS 95811

Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, with initiation of continuous positive airway pressure therapy or bilevel ventilation, attended by a technologist

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$123.67 / $136.24 / $734.35
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$633.16 / $821.92 / $3,067.00
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$117.84 / $141.65 / $576.00
Aetna
Facility/Professional
Professional
Modifier
52
Low / Median / High Price
$276.43 / $342.47 / $516.49
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$481.29 / $655.83 / $1,607.92
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$550.52 / $653.74 / $1,176.63
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$105.19 / $141.44 / $158.35
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$579.36 / $885.20 / $1,887.32
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$110.90 / $174.31 / $387.47
Anthem BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$412.51 / $716.51 / $1,548.30
Blue Shield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$445.78 / $668.52 / $1,594.13
Blue Shield
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$81.64 / $111.43 / $270.37
Blue Shield
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$369.47 / $557.09 / $1,313.49
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$697.16 / $1,017.45 / $1,952.63
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$130.00 / $193.60 / $354.66
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$574.53 / $834.28 / $1,613.36
Contra Costa Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$357.72 / $544.42 / $1,172.06
Contra Costa Health
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$135.16 / $168.13 / $213.23
Contra Costa Health
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$189.59 / $288.55 / $989.59
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$638.07 / $818.21 / $1,420.72
Kaiser Permanente
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$112.37 / $136.57 / $283.29
Kaiser Permanente
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$565.75 / $733.03 / $1,246.15
Lucent Health
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$286.83 / $753.90 / $753.90
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,200.00 / $6,200.00 / $6,200.00
Lucent Health
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$1,081.48 / $1,081.48 / $1,081.48
Lucent Health
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$3,875.48 / $3,991.74 / $4,567.58
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $32.34 / $887.90
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$743.83 / $1,124.71 / $1,780.47
Providence
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$132.34 / $197.31 / $337.53
Providence
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$583.17 / $874.72 / $1,613.36
Sutter Health Plus
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,137.31 / $2,137.31 / $2,137.31
Sutter Health Plus
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$412.32 / $412.32 / $412.32
Sutter Health Plus
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$1,724.98 / $1,724.98 / $1,724.98
The Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$536.58 / $789.94 / $976.16
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$503.44 / $791.12 / $1,973.93
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$100.24 / $161.10 / $347.61
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$408.51 / $627.88 / $1,577.35