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Ohio rates for HCPCS 0496T

Initiation and monitoring marginal (extended) cadaver donor lung(s) organ perfusion system by physician or qualified health care professional, including physiological and laboratory assessment (eg, pulmonary artery flow, pulmonary artery pressure, left atrial pressure, pulmonary vascular resistance, mean/peak and plateau airway pressure, dynamic compliance and perfusate gas analysis), including bronchoscopy and X ray when performed; each additional hour (List separately in addition to code for primary procedure)

Facilitymedian $7,079 · 10th–90th $1,698–$11,7490%20%10th90th$7,079Professionalmedian $245 · 10th–90th $162–$3890%20%10th90th$245$5.0$20.0$100.0$500.0$2.0K$10.0K$50.0K

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
Facility
Modifier
Typical Low / Median / Typical High
$2,691.53 / $9,549.93 / $11,748.98
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $245.47 / $323.59
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,698.24 / $3,548.13 / $15,135.61
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $199.53 / $316.23
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$239.88 / $3,715.35 / $45,708.82
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$316.23 / $4,073.80 / $7,244.36
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $50.12 / $60.26
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $60.26 / $75.86
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,819.70 / $3,090.30 / $5,754.40
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $302.00 / $478.63