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Drainage Of A Complicated Mouth Lining Infection

Illinois rates for HCPCS 40801

This is a procedure to surgically drain a collection of pus, fluid, or blood that has built up in the tissue lining between the lips or cheeks and the gums, in a case that is more involved than a straightforward drainage. It relieves pressure and helps clear the infection or fluid buildup.

Rates data updated July 2026.

How much does Drainage Of A Complicated Mouth Lining Infection cost?

$363

Typical negotiated rate. In Illinois, July 2026.

Insurers have agreed to pay about $363 for this service. The price depends on where it is billed: about $331 from a physician practice, and about $1,318 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 6 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$331$263 to $447
FacilityA hospital or hospital-owned outpatient department$1,318$562 to $3,236

How much rates vary

Facilitymedian $1,318 · 10th to 90th $288 to $5,370Professionalmedian $331 · 10th to 90th $195 to $589
$200$500$1K$2K$5K$10Kfacility $1,318professional $331

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. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$288.40
Median
$1,584.89
Typical High
$5,623.41
Aetna
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$288.40
Typical High
$630.96
BCBS
Setting
Facility
Modifier
Global
Typical Low
$676.08
Median
$831.76
Typical High
$3,235.94
BCBS
Setting
Professional
Modifier
Global
Typical Low
$223.87
Median
$346.74
Typical High
$549.54
Cigna
Setting
Professional
Modifier
Global
Typical Low
$204.17
Median
$323.59
Typical High
$524.81
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$234.42
Median
$416.87
Typical High
$870.96
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$245.47
Median
$251.19
Typical High
$389.05
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$32.36
Typical High
$33.11
United
Setting
Facility
Modifier
Global
Typical Low
$223.87
Median
$691.83
Typical High
$2,089.30
United
Setting
Professional
Modifier
Global
Typical Low
$223.87
Median
$346.74
Typical High
$588.84

Where Illinois sits

The same service costs 9.5 times more in California than in West Virginia. 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.

Illinois· 28th of 51

$363

CA $2,630WV $275

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.