go back

Texas rates for HCPCS 22103

Prtl Exc Pst Vrt Intrnsc B1y Les 1 Vrt Sgm Ea

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$727.00 / $3,213.00 / $11,453.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,582.00 / $5,863.40 / $14,754.00
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$80.00 / $113.67 / $117.93
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$152.81 / $3,603.00 / $6,702.00
Cigna
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$14.95 / $14.95 / $14.95
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $2,000.00 / $4,044.74
Lucent Health
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$29.39 / $60.40 / $63.40
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$128.05 / $178.93 / $276.02
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$128.44 / $179.84 / $293.48
Providence
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$14.95 / $14.95 / $43.57
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$161.00 / $949.00 / $2,290.00