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Washington rates for HCPCS 0485T

Optical coherence tomography (OCT) of middle ear, with interpretation and report; unilateral

Facilitymedian $30 · 10th–90th $12–$1380%10%10th90th$30Professionalmedian $39 · 10th–90th $17–$650%10%10th90th$39$5.0$10.0$20.0$50.0$100.0$200.0

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
$60.26 / $60.26 / $60.26
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.98 / $38.02 / $60.26
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$77.62 / $107.15 / $218.78
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $52.48 / $83.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.59 / $13.18 / $15.85
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$34.67 / $100.00 / $158.49
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $51.29 / $51.29
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $50.12 / $75.86
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12.02 / $17.78 / $29.51
Pacific Source
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.89 / $12.02 / $17.78
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$25.70 / $81.28 / $81.28
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.70 / $45.71 / $85.11
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$74.13 / $112.20 / $218.78
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $52.48 / $83.18
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$17.38 / $109.65 / $208.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$20.42 / $40.74 / $87.10
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $109.65 / $109.65