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Virginia 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
$158.31 / $285.27 / $456.12
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.52 / $150.00 / $165.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.78 / $133.24 / $217.74
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
$111.80 / $131.87 / $164.83
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$109.95 / $151.32 / $225.00
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.45 / $111.62 / $253.13
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$70.25 / $131.62 / $295.57
Sentara
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.70 / $155.55 / $350.36
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$84.95 / $147.15 / $228.20