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Texas rates for HCPCS 01922

Anes Non-Invasive Imaging/Radiation Therapy

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$42.00 / $50.00 / $484.80
Aetna
Facility/Professional
Professional
Modifier
AA
Low / Median / High Price
$805.80 / $996.00 / $2,660.00
Aetna
Facility/Professional
Professional
Modifier
QK
Low / Median / High Price
$78.67 / $255.15 / $550.54
Aetna
Facility/Professional
Professional
Modifier
QX
Low / Median / High Price
$242.55 / $343.35 / $700.70
Aetna
Facility/Professional
Professional
Modifier
QZ
Low / Median / High Price
$206.32 / $206.32 / $206.32
Ambetter
Facility/Professional
Professional
Modifier
AA
Low / Median / High Price
$334.07 / $785.00 / $1,445.00
Ambetter
Facility/Professional
Professional
Modifier
QK
Low / Median / High Price
$100.30 / $353.25 / $667.25
Ambetter
Facility/Professional
Professional
Modifier
QX
Low / Median / High Price
$94.91 / $359.13 / $637.50
Ambetter
Facility/Professional
Professional
Modifier
QZ
Low / Median / High Price
$200.60 / $715.00 / $1,120.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,456.92 / $5,821.21 / $8,577.84
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.17 / $91.90 / $91.90
Cigna
Facility/Professional
Professional
Modifier
QK
Low / Median / High Price
$240.00 / $240.00 / $240.00
Cigna
Facility/Professional
Professional
Modifier
QX
Low / Median / High Price
$240.00 / $240.00 / $240.00
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$82.00 / $104.00 / $104.00
Lucent Health
Facility/Professional
Facility
Modifier
QK
Low / Median / High Price
$37.00 / $39.50 / $52.00
Lucent Health
Facility/Professional
Facility
Modifier
QX
Low / Median / High Price
$37.00 / $39.50 / $52.00
Lucent Health
Facility/Professional
Facility
Modifier
QY
Low / Median / High Price
$37.00 / $39.50 / $52.00
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$105.80 / $3,000.00 / $6,105.00
Moda Health
Facility/Professional
Professional
Modifier
QK
Low / Median / High Price
$82.88 / $201.67 / $336.45
Moda Health
Facility/Professional
Professional
Modifier
QX
Low / Median / High Price
$125.00 / $240.00 / $358.88
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$105.80 / $2,500.00 / $6,105.00
Providence
Facility/Professional
Facility
Modifier
QK
Low / Median / High Price
$325.60 / $325.60 / $325.60
Providence
Facility/Professional
Facility
Modifier
QX
Low / Median / High Price
$325.60 / $325.60 / $325.60
Providence
Facility/Professional
Facility
Modifier
QY
Low / Median / High Price
$325.60 / $325.60 / $325.60
Providence
Facility/Professional
Professional
Modifier
QK
Low / Median / High Price
$232.00 / $288.00 / $350.28
Providence
Facility/Professional
Professional
Modifier
QX
Low / Median / High Price
$232.00 / $288.00 / $350.28