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Ohio rates for HCPCS L8631

Metacarpophalangeal joint replacement, two or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon), for surgical implantation (all sizes, includes entire system)

Facilitymedian $1,549 · 10th–90th $1,288–$2,1880%20%40%10th90th$1,549Professionalmedian $1,349 · 10th–90th $1,148–$2,5120%20%40%10th90th$1,349$2.0$10.0$50.0$200.0$1.0K$5.0K

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
$1,288.25 / $1,288.25 / $2,187.76
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,318.26 / $2,137.96
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,318.26 / $1,698.24 / $3,548.13
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,348.96 / $2,290.87 / $3,235.94
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,778.28 / $2,454.71 / $3,630.78
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,479.11 / $1,479.11 / $1,548.82
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,258.93 / $1,258.93 / $1,479.11
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,479.11 / $1,479.11 / $1,479.11
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,258.93 / $1,258.93 / $1,479.11
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,445.44 / $2,238.72 / $3,311.31
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,570.40 / $3,019.95 / $5,623.41
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$977.24 / $1,778.28 / $1,862.09
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$891.25 / $1,318.26 / $1,819.70