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Texas rates for HCPCS G0383

Level 4 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
Professional
Modifier
Low / Median / High Price
$232.96 / $232.96 / $249.32
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$251.55 / $737.04 / $1,317.63
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$80.00 / $80.00 / $80.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$681.46 / $681.46 / $681.46
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$232.96 / $232.96 / $493.88
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$213.44 / $234.02 / $390.11
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$232.96 / $232.96 / $493.88
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$681.46 / $681.46 / $681.46
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$94.97 / $94.97 / $132.96