go back

Texas rates for HCPCS G0454

Physician documentation of face-to-face visit for durable medical equipment determination performed by nurse practitioner, physician assistant or clinical nurse specialist

Facilitymedian $10 · 10th–90th $7$200%10%10th90th$10Professionalmedian $8 · 10th–90th $6$110%20%10th90th$8$0.1$0.5$2.0$10.0$50.0

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
$5.01 / $5.01 / $5.01
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.03 / $7.94 / $10.00
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.17 / $7.24 / $7.24
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7.59 / $83.18 / $83.18
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$13.49 / $13.49 / $13.49
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.32 / $8.32 / $8.32
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$75.86 / $85.11 / $85.11
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $70.79 / $70.79
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7.24 / $10.00 / $17.38
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.03 / $8.32 / $14.79
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $33.11
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.94 / $16.60 / $32.36
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7.24 / $9.77 / $17.38
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.32 / $8.32 / $17.78
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7.08 / $8.71 / $13.18
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.41 / $9.77 / $15.85
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.24 / $9.12 / $10.96