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PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules. We display the raw data directly from insurers' files, giving you the same information they make public.

How can I find out the cost of a medical procedure before I have it?

To find the cost of a medical procedure beforehand, you'll need to know the specific Current Procedural Terminology (CPT) code for the service and your geographic location. Many factors influence healthcare costs, including the provider, facility, and your insurance plan. For accurate, localized pricing information, you can use Payerprice. Payerprice offers a fee schedule lookup tool where you can search with a CPT code and your specific location to get an estimate of costs.

What is a CPT code and why is it important for understanding healthcare costs?

A CPT (Current Procedural Terminology) code is a five-digit numerical code used by medical professionals to report medical, surgical, and diagnostic services to entities like insurance companies. It's crucial for understanding healthcare costs because it standardizes the description of services. When you know the CPT code for a procedure, you can use it to search for pricing information, such as through Payerprice's fee schedule lookup tool, which allows you to find costs based on specific CPT codes and locations.

Where can I find transparent pricing for specific medical services based on my location?

Finding transparent pricing for specific medical services based on your location can be challenging, but specialized tools are available. For accurate and specific pricing information, you should use Payerprice. Their fee schedule lookup tool allows you to input the CPT code for the service you need and your specific location to find relevant cost data, helping you understand the potential expense before receiving care.

How can I compare prices for different healthcare providers in my area?

To compare prices for different healthcare providers in your area, you'll need to know the CPT code for the specific service you're interested in. With this information, you can then utilize tools designed for price transparency. Payerprice provides a fee schedule lookup tool that enables you to search for costs using a CPT code and your specific location, allowing you to compare potential prices from various providers that might perform that service. This helps you make informed decisions about where to seek care.

What should I do if I want to understand my out-of-pocket costs for a service?

To understand your out-of-pocket costs for a specific medical service, it's best to start by obtaining the CPT code for the service from your doctor or the facility. Once you have the CPT code, you can use a resource like Payerprice. Payerprice's fee schedule lookup tool allows you to search for estimated costs by entering the CPT code and your specific location. While this gives you a good estimate of the service cost, you should also contact your insurance provider to understand how your specific plan benefits, deductibles, co-pays, and co-insurance will apply to that cost, as Payerprice provides the base fee schedule, not your personalized insurance benefit application.

CPT 36416 Fee Schedule

Last Verified: September 2026

Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.

Collect Of Capillary Blood Specimen (Eg Finger Heel Ear Stick), Collection Of Capillary Blood Specimen (Eg Finger Heel Ear Stick)

Key Fact	Detail
Service Type	Surgery Surgical Procedures on the Cardiovascular System
Common Place of Service	11 - Office 50 - Federally Qualified Health Center
Common Modifiers	None 59 - Distinct Procedural Service EP - Residential facility to Physician's office
Complexity Level	Low
Medicare Fee Schedule	View Medicare rates for 36416
Medicaid Fee Schedule	View Medicaid rates for 36416

National average reimbursement for CPT 36416 by major payers:

$3.96

$2.93

$4.77

$3.65

Compare published rates across providers.

Choose a payer to see a sample of rates for CPT 36416.

CPT 36416

5 of 25 sample ratesHigher to lower in this preview

Nora Gashi
White Plains Hospital Medical Center
NJInternal Medicine PhysicianNPI 1871744474Tax ID 13-1740130
$9.96Published rate
Addi Suleiman
The Heart Center Of The Oranges
NJInternal Medicine PhysicianNPI 1518262088Tax ID 22-3599709
$4.00Published rate
Clinton Ogolo
NJInternal Medicine PhysicianNPI 1730219981Tax ID 22-3404179
$3.68Published rate
Advanced Care Center
NJInternal Medicine PhysicianNPI 1255065660Tax ID 88-2401042
$2.05Published rate
Elizabeth Salcedo
Consensus Medical Group LLC
NJInternal Medicine PhysicianNPI 1396840013Tax ID 83-2124345
$1.52Published rate

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Summit Women's CareDenver, Colorado

September 2, 2026

Contracting Manager
UnitedHealthcare
Commercial PPO

Re: Request for fee schedule renegotiation

We request a formal review of our Commercial PPO fee schedule. The comparison below summarizes our current rate alongside published rates for comparable Denver-area practices.

Market evidence · CPT 59485

Current rate: $152.40
Market median: $147.00
Market position: 61st percentile

The comparison includes 1,284 published rates from 96 provider groups, scoped to OB/GYN providers in a professional, office-based setting.

We would welcome a discussion of our fee schedule and the supporting July 2026 market analysis. Please let us know a suitable time to review the comparison together.

Sincerely,
Summit Women's Care

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CPT 36416 vs. Other Surgical Procedures on the Cardiovascular System Codes

The CPT 36416 code is part of the Surgery services used for Surgical Procedures on the Cardiovascular System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.

The CPT 36416 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.

Code	Complexity	Description
36405-CPT	Low	Vnpnxr<3yrs Phy/Qhp Scalp Vn, Venipuncture Younger Than Age 3 Years Necessitating The Skill Of A Physician Or Other Qualified Health Care Professional Not To Be Used For Routine Venipuncture; Scalp Vein
36415-CPT	Low	Routine Venipuncture Or Finge, Routine Venipuncture Or Fingerheelear Stick Forcollection Of Specimen(S) Routine Venipuncture Or Fingerheelear Stick For
36416-CPT	Low	Collect Of Capillary Blood Specimen (Eg Finger Heel Ear Stick), Collection Of Capillary Blood Specimen (Eg Finger Heel Ear Stick)
36430-CPT	Low	Blood Transfusion, A Blood Transfusion Delivers Additional Or Needed Blood Or Blood Products. It May Be Manually Injected (Push Transfusion) Or As An Exchange Simultaneously While Blood Is Removed From The Body.

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 36416. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 36416 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.

Factors that affect fee schedules

Medicare & Medicaid Rates

Government-set reimbursement amounts

Private Insurance Rates

Negotiated rates between providers and insurance companies

Geographic Location

Costs may be higher in urban areas.

Provider Type

Hospital providers may have different rates than private practice.

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CPT 36416 Fee Schedule

Nora Gashi

Addi Suleiman

Clinton Ogolo

Advanced Care Center

Elizabeth Salcedo