go back

Texas rates for HCPCS 00104

Anesthesia for electroconvulsive therapy

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
AA
Low / Median / High Price
$398.11 / $630.96 / $831.76
Ambetter
Facility/Professional
Professional
Modifier
AA
Low / Median / High Price
$120.23 / $323.59 / $457.09
Lucent Health
Facility/Professional
Facility
Modifier
QK
Low / Median / High Price
$52.48 / $52.48 / $52.48
Lucent Health
Facility/Professional
Facility
Modifier
QX
Low / Median / High Price
$52.48 / $52.48 / $52.48
Lucent Health
Facility/Professional
Facility
Modifier
QY
Low / Median / High Price
$52.48 / $52.48 / $52.48
Moda Health
Facility/Professional
Professional
Modifier
AA
Low / Median / High Price
$100.00 / $537.03 / $831.76
Providence
Facility/Professional
Facility
Modifier
QK
Low / Median / High Price
$30.90 / $30.90 / $30.90
Providence
Facility/Professional
Facility
Modifier
QX
Low / Median / High Price
$30.90 / $30.90 / $30.90
Providence
Facility/Professional
Facility
Modifier
QY
Low / Median / High Price
$30.90 / $30.90 / $30.90