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Texas rates for HCPCS G0384

Level 5 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 $324 · 10th–90th $257–$9550%20%10th90th$324Professionalmedian $288 · 10th–90th $195–$4680%50%10th90th$288$1.0$5.0$20.0$100.0$500.0$2.0K

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
$275.42 / $288.40 / $467.74
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$371.54 / $1,047.13 / $1,949.84
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$549.54 / $549.54 / $549.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $190.55 / $190.55
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
$288.40 / $295.12 / $831.76
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $288.40 / $512.86
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
$275.42 / $295.12 / $831.76
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $190.55 / $190.55
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $323.59 / $776.25
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $147.91 / $186.21