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Pennsylvania 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
$136.03 / $320.23 / $499.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.38 / $136.03 / $158.31
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,000.00 / $8,639.91 / $79,506.39
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.98 / $115.27 / $188.98
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$127.22 / $127.22 / $127.22
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$88.53 / $88.53 / $88.53
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$95.53 / $139.86 / $182.69
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$157.02 / $722.00 / $1,342.09
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$173.68 / $173.68 / $173.68
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$136.03 / $320.23 / $2,350.81
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$103.63 / $136.03 / $178.03
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$233.70 / $233.70 / $765.79
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$127.22 / $127.22 / $127.22
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$88.53 / $88.53 / $88.53
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$87.47 / $87.47 / $191.58
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.47 / $94.00 / $179.90
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$93.26 / $145.02 / $222.45