go back

Maryland rates for HCPCS G0400

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.38 / $127.53 / $180.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$88.53 / $88.53 / $88.53
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.44 / $131.87 / $178.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.83 / $125.78 / $228.22