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Ohio 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
$138.04 / $186.21 / $295.12
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.44 / $776.25 / $1,380.38
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$117.49 / $199.53 / $389.05
Aetna
Facility/Professional
Professional
Modifier
52
Low / Median / High Price
$194.98 / $257.04 / $1,258.93
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$467.74 / $616.60 / $1,096.48
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$537.03 / $616.60 / $933.25
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$112.20 / $131.83 / $218.78
Ambetter
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$457.09 / $524.81 / $575.44
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$616.60 / $831.76 / $1,380.38
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$109.65 / $154.88 / $257.04
Anthem BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$501.19 / $691.83 / $1,122.02
Aultcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$660.69 / $660.69 / $660.69
Aultcare
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$120.23 / $120.23 / $120.23
Aultcare
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$537.03 / $537.03 / $537.03
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.90 / $575.44 / $851.14
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$29.51 / $138.04 / $199.53
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$588.84 / $891.25 / $1,659.59
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$114.82 / $173.78 / $316.23
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$478.63 / $707.95 / $1,318.26
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$29.51 / $138.04 / $199.53
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Low / Median / High Price
$489.78 / $851.14 / $1,479.11
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$104.71 / $165.96 / $316.23
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
52
Low / Median / High Price
$173.78 / $173.78 / $173.78
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$457.09 / $691.83 / $1,288.25
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $346.74
SummaCare
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$100.00 / $100.00 / $1,047.13
SummaCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$691.83 / $794.33 / $1,513.56
SummaCare
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$125.89 / $154.88 / $281.84
SummaCare
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$562.34 / $645.65 / $1,230.27
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$549.54 / $776.25 / $1,318.26
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$107.15 / $158.49 / $269.15
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$446.68 / $616.60 / $1,047.13