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Ohio rates for HCPCS 0523T

Intraprocedural coronary fractional flow reserve (FFR) with 3D functional mapping of color-coded FFR values for the coronary tree, derived from coronary angiogram data, for real-time review and interpretation of possible atherosclerotic stenosis(es) intervention (List separately in addition to code for primary procedure)

Facilitymedian $355 · 10th–90th $105–$2,1880%10%20%10th90th$355Professionalmedian $110 · 10th–90th $89–$2,8840%10%20%10th90th$110$2.0$10.0$50.0$200.0$1.0K$5.0K$20.0K

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
$104.71 / $177.83 / $354.81
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $102.33 / $147.91
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,041.74 / $2,570.40 / $4,073.80
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$74.13 / $1,096.48 / $41,686.94
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $1,230.27 / $2,187.76
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
$478.63 / $1,047.13 / $3,235.94
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $199.53 / $316.23