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Texas rates for HCPCS D0367

cone beam CT capture and interpretation with field of view of both jaws; with or without cranium

Facilitymedian $191 · 10th–90th $129–$4470%20%10th90th$191Professionalmedian $174 · 10th–90th $129–$2450%20%10th90th$174$1.0$5.0$20.0$100.0$500.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $128.82 / $134.90
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $173.78 / $245.47
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $79.43 / $79.43
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,096.48 / $1,096.48
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,737.80 / $1,737.80
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$128.82 / $190.55 / $331.13
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $151.36 / $223.87
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $30.20
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $389.05 / $389.05
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$131.83 / $190.55 / $338.84
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $79.43 / $245.47
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $302.00 / $371.54