12 payers file a negotiated rate for this code. Each is shown once, under the terms the most hospitals file it under; rates under different terms (billing class, payment method, setting) are never blended, so open a payer to see them all. Figures are hospital-level averages; the median is across hospitals.
Filter by billing methodology
Filter by billing class
| # | |||||
|---|---|---|---|---|---|
| 1 | Aetna percent of total billed charges · outpatientfrom % of charges | 4 | $32.50 | $30.82 | $4.00 – $93.00 |
| 2 | Cigna percent of total billed charges · outpatientfrom % of charges | 4 | $28.25 | $35.07 | $4.00 – $102.00 |
| 3 | Bcbs Tx percent of total billed charges · outpatientfrom % of charges | 2 | $19.75 | $19.67 | $7.00 – $32.00 |
| 4 | Blue Cross Blue Shield percent of total billed charges · outpatientfrom % of charges | 2 | $29.88 | $25.50 | $3.00 – $98.00 |
| 5 | MultiPlan percent of total billed charges · outpatientfrom % of charges | 2 | $26.38 | $31.83 | $5.00 – $81.00 |
| 6 | Anthem fee schedule · outpatient · +1 other terms | 1 | $19.50 | $19.50 | $8.00 – $37.00 |
| 7 | First Health percent of total billed charges · outpatientfrom % of charges | 1 | $8.00 | $8.00 | $8.00 – $8.00 |
| 8 | Humana fee schedule · outpatient | 1 | $11.00 | $11.00 | $11.00 – $11.00 |
| 9 | Phcs percent of total billed charges · outpatientfrom % of charges | 1 | $9.50 | $9.50 | $5.00 – $14.00 |
| 10 | Superior Healthplan fee schedule · outpatient | 1 | $8.75 | $8.75 | $4.00 – $15.00 |
| 11 | UnitedHealthcare fee schedule · outpatient · +2 other terms | 1 | $19.50 | $19.50 | $8.00 – $37.00 |
| 12 | WellCare fee schedule · outpatient | 1 | $20.00 | $20.00 | $8.00 – $38.00 |
← Hospitals reporting CPT 40917 · Snapshot 20261109T115250Z-6452cf6e