go back

Texas rates for HCPCS 93923

Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries, 3 or more levels (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis arteries plus segmental blood pressure measurements with bidirectional Doppler waveform recording and analysis, at 3 or more levels, or ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis arteries plus segmental volume plethysmography at 3 or more levels, or ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis arteries plus segmental transcutaneous oxygen tension measurements at 3 or more levels), or single level study with provocative functional maneuvers (eg, measurements with postural provocative tests, or measurements with reactive hyperemia)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$118.66 / $551.00 / $1,455.17
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$16.18 / $19.91 / $34.95
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.86 / $151.71 / $302.06
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$16.18 / $21.30 / $39.93
Aetna
Facility/Professional
Professional
Modifier
52
Low / Median / High Price
$51.85 / $63.23 / $97.55
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$83.93 / $114.90 / $204.22
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.78 / $119.68 / $146.01
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$14.03 / $20.04 / $30.06
Ambetter
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$79.70 / $79.70 / $79.70
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$124.87 / $300.83 / $574.41
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.38 / $91.08 / $174.60
Baylor Scott & White
Facility/Professional
Facility
Modifier
Low / Median / High Price
$128.76 / $205.67 / $432.64
Baylor Scott & White
Facility/Professional
Professional
Modifier
Low / Median / High Price
$119.68 / $163.18 / $195.08
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$119.48 / $125.19 / $128.04
Christus
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$19.84 / $29.61 / $29.61
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$145.77 / $413.19 / $600.28
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$24.72 / $24.72 / $24.72
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$122.59 / $177.74 / $299.00
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$21.02 / $27.93 / $46.95
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$104.91 / $148.72 / $257.45
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$272.45 / $696.92 / $696.92
Lucent Health
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$100.00 / $176.87 / $176.87
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,098.83 / $1,173.20 / $1,205.33
Lucent Health
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$310.41 / $310.41 / $310.41
Lucent Health
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$925.73 / $1,048.79 / $1,077.52
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$120.27 / $185.47 / $283.13
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$92.07 / $176.16 / $284.05
Moda Health
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$23.91 / $32.61 / $49.50
Moda Health
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$131.81 / $168.72 / $292.38
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.45 / $119.68 / $222.50
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$121.40 / $187.89 / $331.95
Providence
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$24.72 / $24.72 / $24.72
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$123.87 / $180.01 / $327.55
Providence
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$20.98 / $27.85 / $42.67
Providence
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$106.16 / $148.49 / $250.76
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$112.06 / $157.93 / $269.95
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$18.05 / $24.34 / $41.76
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$94.53 / $131.88 / $230.37
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$107.39 / $119.68 / $170.68
Wellpoint
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$17.39 / $20.04 / $28.06
Wellpoint
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$90.00 / $99.64 / $143.18