Does anyone out there have Highmark open market and get allergy shots/testing?

Submitted by fobreezee t3_10p5396 in pittsburgh

So basically there’s a “negotiated rate” for allergy testing and shots, however nobody can tell the the cost “until it is billed”. If anyone happens to know the rate because my plan is 100% until the deductible is met. Does anyone know off the top of their head what it might be? If not I guess try to find someone that does not take my insurance is the best thing to do from the sounds of it. Thanks if anyone knows anything.

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burghfan t1_j6it2hz wrote

I just got tested. They listed to cost as $536 for standard skin testing including a breathing test and consulting fee at ENT & allergy specialists of western pa.

The paperwork from my dr's office says the codes are 95004 and 95024 for skin testing and 94010 for the breathing test.

Paperwork also says that injections are $215 for one bottle, $300 for 2, $445 for 3+, depending on your treatment needs. Bottles will last 2-4 months. Injection fees are $25/1 or $30 for multiple.

I opted to go with a different treatment plan (drops) which are not covered by insurance. They are $280 every 11 weeks. Saves me having to go into the office for the shots.

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fobreezee OP t1_j6j4meq wrote

>I opted to go with a different treatment plan (drops) which are not covered by insurance. They are $280 every 11 weeks. Saves me having to go into the office for the shots.

Thanks a ton for all the details! I wonder what it costs without the breathing tests? I'm allergic to stuff like molds, mites, trees, weeds and grass. Is this basically the same stuff you got tested for or did you get tested for other things too?

I never heard of drops either! I've been getting shots for years. How are they going for you? How does it work exactly? Do you take them by mouth? Also, what are you allergic to?

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burghfan t1_j6j5whx wrote

I was tested for weeds, trees, molds, animals, etc. Allergic to all of the above.

I haven't started treatment yet. They are sub-lingual immunotherapy drops (under the tongue) or SLIT. They are custom mixed like shots, say they can be effective in as little as 8 weeks. I chose them because shots were going to be had for me with time and travel.

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Naa2016 t1_j6kbqlo wrote

While it's true that healthcare practices will not know the exact amount you will owe, they SHOULD know which CPT codes (the codes used for billing) are going to be billed. Ask for that information, and ask your insurance what the payable amount will likely be for each code.

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Formal_Development_4 t1_j6o9w4p wrote

My doctor suggested just taking allergy medicine and forget the testing unless you are having some very serious reactions to something. You can learn to give yourself allergy shots. The biggest risk is that you will have a strong reaction, hence why you usually have to wait at the office for 15 minutes to be observed after your shot.

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