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Draining An Abscess In The Mouth Vestibule

South Dakota rates for HCPCS 40800

Opens and drains a pocket of pus, fluid or blood in the vestibule of the mouth, the space between the lips or cheek and the gums. A small cut is made through the lining, the collection is emptied and the area is rinsed out. This is the straightforward version, used when a single pocket can be opened and cleared in one step.

Rates data updated July 2026.

How much does Draining An Abscess In The Mouth Vestibule cost?

$240

Typical negotiated rate. In South Dakota, July 2026.

Insurers have agreed to pay about $240 for this service. The price depends on where it is billed: about $234 from a physician practice, and about $282 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 7 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$234$178 to $363
FacilityA hospital or hospital-owned outpatient department$282$195 to $562

How much rates vary

Facilitymedian $282 · 10th to 90th $126 to $4,365Professionalmedian $234 · 10th to 90th $115 to $490
$100$200$500$1K$2Kfacility $282professional $234

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$4,365.16
Typical High
$4,365.16
Aetna
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$177.83
Typical High
$223.87
Cigna
Setting
Professional
Modifier
Global
Typical Low
$288.40
Median
$363.08
Typical High
$616.60
Medica
Setting
Facility
Modifier
Global
Typical Low
$147.91
Median
$269.15
Typical High
$562.34
Medica
Setting
Professional
Modifier
Global
Typical Low
$181.97
Median
$398.11
Typical High
$1,513.56
Midlands
Setting
Professional
Modifier
Global
Typical Low
$263.03
Median
$295.12
Typical High
$478.63
Midlands
Setting
Professional
Modifier
Global
Typical Low
$257.04
Median
$257.04
Typical High
$426.58
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$199.53
Median
$275.42
Typical High
$398.11
United
Setting
Facility
Modifier
Global
Typical Low
$1,659.59
Median
$1,659.59
Typical High
$1,659.59
United
Setting
Professional
Modifier
Global
Typical Low
$162.18
Median
$302.00
Typical High
$575.44
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$257.04
Median
$295.12
Typical High
$537.03

Where South Dakota sits

The same service costs 5.4 times more in California than in Delaware. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

South Dakota· 22nd of 51

$240

CA $1,023DE $191

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.