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Texas rates for HCPCS G0382

Level 3 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)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$189.20 / $189.20 / $189.20
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$206.60 / $242.10 / $242.10
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$166.14 / $486.79 / $870.27
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$103.64 / $121.93 / $121.93
Baylor Scott & White
Facility/Professional
Facility
Modifier
Low / Median / High Price
$70.37 / $70.37 / $107.51
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$80.00 / $80.00 / $80.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.20 / $106.20 / $106.20
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $131.04
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$242.10 / $242.10 / $557.16
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$138.56 / $151.91 / $253.22
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$242.10 / $242.10 / $544.73
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.20 / $106.20 / $106.20
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.73 / $66.73 / $93.42