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Texas rates for HCPCS G0380

Level 1 hospital emergency department visit provided in a type B emergency department; (the ED must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 CFR 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment)

Facilitymedian $234 · 10th–90th $110–$3550%20%40%10th90th$234Professionalmedian $234 · 10th–90th $46–$2340%50%10th$234$1.0$5.0$20.0$100.0$500.0$2.0K$10.0K

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
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $234.42 / $234.42
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$61.66 / $173.78 / $323.59
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $45.71 / $45.71
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
$100.00 / $100.00 / $100.00
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$123.03 / $234.42 / $398.11
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $234.42 / $234.42
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 / $0.60 / $0.60
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$123.03 / $234.42 / $380.19
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $60.26 / $79.43
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $275.42 / $38,018.94
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.22 / $16.22 / $19.95