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Pennsylvania rates for HCPCS 95921

Testing of autonomic nervous system function; cardiovagal innervation (parasympathetic function), including 2 or more of the following: heart rate response to deep breathing with recorded R-R interval, Valsalva ratio, and 30:15 ratio

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$45.71 / $45.71 / $45.71
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$74.13 / $87.10 / $173.78
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$39.81 / $45.71 / $91.20
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$35.48 / $42.66 / $81.28
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.07 / $81.28 / $85.11
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$41.69 / $41.69 / $41.69
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.11 / $87.10 / $147.91
Capital Blue Cross
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$43.65 / $45.71 / $83.18
Capital Blue Cross
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$38.02 / $42.66 / $72.44
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$10.72 / $50.12 / $70.79
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.61 / $100.00 / $199.53
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$40.74 / $56.23 / $97.72
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$24.55 / $44.67 / $97.72
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$93.33 / $138.04 / $186.21
Emblem Health
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$44.67 / $66.07 / $89.13
Emblem Health
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$48.98 / $72.44 / $95.50
Geisinger
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.07 / $102.33 / $169.82
Geisinger
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$43.65 / $53.70 / $89.13
Geisinger
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$18.62 / $48.98 / $85.11
Highmark BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$64.57 / $72.44 / $83.18
Martin's Point
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$45.71 / $45.71 / $45.71
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.62 / $95.50 / $213.80
Martin's Point
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$40.74 / $50.12 / $114.82
Martin's Point
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$36.31 / $47.86 / $102.33
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$74.13 / $134.90 / $173.78
UPMC Health Plan
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$43.65 / $43.65 / $47.86
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.80 / $51.29 / $257.04
UPMC Health Plan
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$42.66 / $43.65 / $47.86
UPMC Health Plan
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$30.20 / $40.74 / $45.71
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.10 / $89.13 / $158.49
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$38.02 / $52.48 / $87.10
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$26.30 / $42.66 / $75.86