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Ohio rates for HCPCS 42215

Palatoplasty for cleft palate; major revision

Facilitymedian $7,762 · 10th–90th $1,349$12,5890%10%20%10th90th$7,762Professionalmedian $794 · 10th–90th $646$1,7380%20%40%10th90th$794$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
$1,348.96 / $8,912.51 / $12,302.69
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$645.65 / $794.33 / $3,162.28
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,905.46 / $4,168.69 / $15,135.61
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$616.60 / $776.25 / $1,230.27
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$660.69 / $741.31 / $3,630.78
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $724.44 / $831.76
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,174.90 / $4,897.79
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$537.03 / $891.25 / $1,513.56
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,174.90 / $5,888.44
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$489.78 / $891.25 / $1,445.44
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $117.49
SummaCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $7,244.36
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $758.58 / $1,445.44
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,047.13 / $6,025.60 / $13,489.63
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$562.34 / $794.33 / $1,258.93