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Ohio rates for HCPCS A4736

Topical anesthetic, for dialysis, per g

Facilitymedian $28 · 10th–90th $28–$280%50%$28Professionalmedian $15 · 10th–90th $1–$150%50%10th$15$1.0$2.0$5.0$10.0$20.0$50.0

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
$27.54 / $27.54 / $27.54
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $15.14 / $15.14
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.29 / $1.48 / $2.24
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$64.57 / $64.57 / $64.57
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.70 / $1.70 / $1.70
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$64.57 / $64.57 / $64.57
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.70 / $1.70 / $1.70
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $50.12 / $60.26
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $60.26 / $75.86
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $69.18 / $83.18