go back

Texas rates for HCPCS 0450T

Insertion of aqueous drainage device, without extraocular reservoir, internal approach, into the subconjunctival space; each additional device (List separately in addition to code for primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$630.96 / $2,511.89 / $7,585.78
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $316.23 / $371.54
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,995.26 / $1,995.26 / $1,995.26
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,398.83 / $2,884.03 / $2,884.03
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$331.13 / $1,862.09 / $6,025.60
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$263.03 / $316.23 / $1,000.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $30.20 / $30.20
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$263.03 / $363.08 / $478.63
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$323.59 / $323.59 / $323.59
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$154.88 / $1,047.13 / $2,691.53
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$251.19 / $338.84 / $512.86
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$199.53 / $199.53 / $199.53