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Iowa rates for HCPCS G0400

Home sleep test (HST) with type IV portable monitor, unattended; minimum of 3 channels

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$137.97 / $347.00 / $506.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$99.62 / $125.97 / $207.53
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.06 / $249.98 / $338.17
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$78.15 / $170.11 / $1,048.08
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$109.23 / $180.02 / $576.41
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$206.48 / $368.91 / $858.36
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$134.06 / $263.94 / $331.05
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$145.32 / $284.88 / $413.43
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$129.00 / $1,203.95 / $1,381.77
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$213.51 / $368.91 / $539.49
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.20 / $80.00 / $80.00