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 $591 to $1,674. That's a 2.8x spread inside the same insurance network, for the same procedure code.
The cheapest facility, West Chester Surgical Suites in West Chester, billed above the combined Medicare reference rate of $475. The most expensive, The Good Samaritan Hospital of Cincinnati in Montgomery, billed roughly 3.5 times the Medicare rate, and 2.8 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 $847 to $4,680, a 5.5x spread and the widest we found in either procedure.
The cheapest facility, Surgicenter Ltd in Newark, billed $847 — comfortably above the combined Medicare reference rate of $672. Central Ohio Endoscopy in Dublin sits close to the network median at $1,212. Adena Health System in Chillicothe, the most expensive, billed $4,680 — 5.5 times the cheapest in-network option and roughly seven times the Medicare rate, for a diagnostic procedure with the same CPT code, in the same state, under the same insurer contract.
What plan design doesn't explain: preventive colonoscopies carry $0 member cost-sharing under the ACA, but diagnostic colonoscopies apply normal deductible and coinsurance. For a self-funded plan, that means the $847-to-$4,680 spread isn't absorbed by the plan sponsor's benefit design. It's paid in full out of the plan's own funds.
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 2.8 to 5.5 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.
Methodology
Total cost = facility fee (Anthem Blue Access contracted rate, this file partition) + representative physician fee (network median: $140 for CPT 62323, $247 for CPT 45378). Facility and physician rates vary independently, so totals shown are representative, not per-claim. Medicare reference = CMS Physician Fee Schedule (professional component) + CMS Ambulatory Surgical Center payment rate (institutional component, since the named facilities are ambulatory surgery centers, not hospitals — the ASC rate, not the higher hospital-outpatient/OPPS rate, is the correct comparison). Source: Anthem Blue Cross Blue Shield Blue Access machine-readable files, published July 2026, Ohio. Institutional sample: n=21 (CPT 62323), n=20 (CPT 45378), covering facilities in Dayton, Cincinnati, Columbus, Athens, Newark, West Chester, and Chillicothe. Named facilities and totals are validated to clear the Medicare reference rate and fall outside Tukey's fences for statistical outliers. This is one of nine Anthem file partitions currently ingested. We expect broader Ohio and multi-state coverage as the remaining partitions are processed.