Same Anthem network, same procedure, 8–13x price swing: what we found in Ohio

The question

Federal and Ohio state price transparency regulation now requires insurers to publish the negotiated rate they've contracted with every in-network facility. Anthem published its Blue Access file for Ohio in July 2026. We pulled two of the most commonly shopped, most schedulable procedures, epidural steroid injection and diagnostic colonoscopy, and asked a simple question: for employees on the exact same plan, how much does where they go actually change what the plan pays?

Finding one: epidural steroid injection

An epidural steroid injection (CPT 62323) is the leading cause of missed work for working-age adults. It's exactly the kind of scheduled, shoppable procedure a high-deductible plan is supposed to reward members for shopping around on. Across 21 Ohio facilities in the Anthem Blue Access network, the total out-of-pocket cost (facility fee plus a representative physician fee) ranged from $473 to $3,758. That's a 7.9x spread inside the same insurance network, for the same procedure code.

The cheapest facility, Gastroenterology Associates in Canton, billed below the combined Medicare reference rate of $809. The most expensive, Whitehall Surgery Center in Pickerington, billed nearly five times the Medicare rate, and 7.9 times the cheapest in-network option, for a member on the identical Anthem plan.

Finding two: diagnostic colonoscopy

The pattern repeats, and it's wider. Across 20 Ohio facilities for diagnostic colonoscopy (CPT 45378), total cost ranged from $364 to $4,680, a 12.9x spread and the widest we found in either procedure.

Central Ohio Endoscopy in Dublin sits close to the network median at $1,212, itself already close to the Medicare combined reference of $1,112. Adena Health System in Chillicothe billed nearly four times that, for a diagnostic procedure with the same CPT code, in the same state, under the same insurer contract.

Why this happens

Facility fees and negotiated rates are set through network-wide contracts, not procedure-by-procedure competition. A large health system can negotiate materially higher rates across its facilities than an independent surgery center or freestanding clinic can, regardless of the actual cost of delivering that specific procedure. The physician fee is comparatively stable (we used the network median in both totals). The facility fee is where nearly all of the variation lives.

What this means for self-funded employers

For a fully insured plan, this variation is largely invisible to the employer. For a self-funded plan, it isn't. Every colonoscopy or injection your employees have costs the plan its full negotiated rate, whichever facility they happened to book. An employee steered toward the highest-cost facility in network, purely by chance or referral pattern, can cost the plan 8 to 13 times what the same care would have cost at another in-network facility a short drive away.

Your employees are booking these appointments right now without knowing this pricing exists. Federal and Ohio state regulation gave them the right to know before they book. VitSee makes that right actionable, surfacing the lower-cost, in-network option at the moment of scheduling instead of after the claim clears.