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New York rates for HCPCS 40816

Excision of lesion of mucosa and submucosa, vestibule of mouth; complex, with excision of underlying muscle

Facilitymedian $3,890 · 10th–90th $490–$9,1200%5%10th90th$3,890Professionalmedian $427 · 10th–90th $309–$1,0720%10%10th90th$427$100.0$500.0$2.0K$10.0K$50.0K

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
$457.09 / $3,090.30 / $7,762.47
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $426.58 / $1,071.52
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,630.27 / $4,786.30 / $9,549.93
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $389.05 / $1,047.13
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$426.58 / $1,698.24 / $6,165.95
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$426.58 / $426.58 / $575.44
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$512.86 / $4,365.16 / $53,703.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $676.08 / $1,548.82
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$302.00 / $363.08 / $1,071.52
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$436.52 / $588.84 / $851.14
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $537.03 / $1,000.00
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$323.59 / $50,118.72 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $524.81 / $851.14
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,137.96 / $3,981.07 / $9,120.11
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $478.63 / $1,122.02
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$251.19 / $363.08 / $1,230.27
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $524.81 / $1,071.52