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Pennsylvania rates for HCPCS 40816

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

Facilitymedian $3,802 · 10th–90th $955–$8,3180%10%10th90th$3,802Professionalmedian $398 · 10th–90th $295–$7940%20%10th90th$398$10.0$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
$954.99 / $3,890.45 / $8,317.64
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $389.05 / $831.76
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,456.54 / $6,606.93 / $57,543.99
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $457.09 / $457.09
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $426.58 / $660.69
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $660.69 / $691.83
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,479.11 / $1,479.11 / $1,479.11
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$316.23 / $489.78 / $724.44
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,174.90 / $6,918.31 / $10,964.78
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$724.44 / $2,454.71 / $8,317.64
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $407.38 / $954.99
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$380.19 / $645.65 / $891.25
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$316.23 / $389.05 / $416.87
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $389.05 / $426.58
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,659.59 / $3,981.07 / $10,715.19
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $398.11 / $676.08