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New Hampshire 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
$132.97 / $228.68 / $564.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$584.29 / $730.48 / $1,158.85
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$108.16 / $132.01 / $224.47
Aetna
Facility/Professional
Professional
Modifier
52
Low / Median / High Price
$258.47 / $336.16 / $480.85
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$476.14 / $588.83 / $934.39
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$33.86 / $153.06 / $387.20
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$622.97 / $779.05 / $1,283.03
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$117.09 / $149.91 / $235.77
Anthem BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$508.05 / $629.14 / $1,047.27
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$774.54 / $1,160.46 / $2,049.50
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$139.29 / $226.65 / $411.38
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$635.24 / $917.71 / $1,615.41
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$729.49 / $1,202.56 / $2,251.57
Harvard Pilgrim
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$134.05 / $220.51 / $413.75
Harvard Pilgrim
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$595.44 / $979.50 / $1,837.83
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$761.86 / $1,108.46 / $2,182.73
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$146.33 / $208.80 / $369.86
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$588.84 / $881.74 / $1,773.01
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$565.22 / $683.08 / $973.21
Well Sense
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$96.97 / $135.76 / $196.75
Well Sense
Facility/Professional
Professional
Modifier
52
Low / Median / High Price
$188.94 / $226.73 / $255.07
Well Sense
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$416.87 / $521.09 / $789.55