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Ohio rates for HCPCS L8604

Injectable bulking agent, dextranomer/hyaluronic acid copolymer implant, urinary tract, 1 ml, includes shipping and necessary supplies

Facilitymedian $708 · 10th–90th $95–$28,8400%20%10th90th$708Professionalmedian $2,399 · 10th–90th $95–$2,3990%20%40%10th$2,399$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
$95.50 / $707.95 / $28,840.32
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $2,398.83 / $2,398.83
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $128.82 / $199.53
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,943.28 / $7,943.28 / $7,943.28
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$34.67 / $50.12 / $60.26