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Ohio rates for HCPCS 42260

Repair of nasolabial fistula

Facilitymedian $5,012 · 10th–90th $933$12,0230%5%10%10th90th$5,012Professionalmedian $851 · 10th–90th $617$1,5490%20%10th90th$851$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
$912.01 / $5,128.61 / $12,022.64
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $851.14 / $1,949.84
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,071.52 / $3,388.44 / $12,882.50
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$501.19 / $776.25 / $1,230.27
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$630.96 / $707.95 / $3,630.78
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$707.95 / $707.95 / $794.33
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$691.83 / $1,148.15 / $4,897.79
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$616.60 / $954.99 / $1,698.24
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$691.83 / $1,148.15 / $5,888.44
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $954.99 / $1,548.82
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $100.00
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
$602.56 / $891.25 / $1,621.81
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$870.96 / $4,570.88 / $8,709.64
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $831.76 / $1,348.96