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Missouri 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
$120.32 / $168.46 / $999.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$593.96 / $821.91 / $2,855.30
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$118.48 / $145.52 / $576.00
Aetna
Facility/Professional
Professional
Modifier
52
Low / Median / High Price
$258.77 / $342.47 / $461.84
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$472.98 / $654.21 / $1,818.70
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$824.89 / $824.89 / $824.89
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$104.91 / $151.72 / $196.27
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$588.36 / $740.47 / $1,238.76
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$118.88 / $148.00 / $316.06
Anthem BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$472.31 / $600.97 / $973.73
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$648.30 / $935.61 / $1,372.17
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$124.63 / $186.18 / $288.50
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$500.00 / $741.51 / $1,103.03
Medica
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$286.83 / $753.90 / $753.90
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$631.15 / $973.30 / $6,200.00
Medica
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$122.11 / $209.82 / $1,081.48
Medica
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$503.07 / $778.43 / $3,875.48
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$595.23 / $853.39 / $1,517.92
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$120.17 / $179.70 / $310.94
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$467.72 / $670.63 / $1,209.88