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Drainage Of A Complicated Mouth Lining Infection

North Carolina 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?

$355

Typical negotiated rate. In North Carolina, July 2026.

Insurers have agreed to pay about $355 for this service. The price depends on where it is billed: about $347 from a physician practice, and about $851 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$347$263 to $562
FacilityA hospital or hospital-owned outpatient department$851$324 to $5,012

How much rates vary

Facilitymedian $851 · 10th to 90th $219 to $6,918Professionalmedian $347 · 10th to 90th $195 to $776
$200$500$1K$2K$5Kfacility $851professional $347

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
$281.84
Median
$1,288.25
Typical High
$7,244.36
Aetna
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$288.40
Typical High
$660.69
BCBS
Setting
Professional
Modifier
Global
Typical Low
$269.15
Median
$512.86
Typical High
$831.76
Cigna
Setting
Professional
Modifier
Global
Typical Low
$251.19
Median
$380.19
Typical High
$676.08
Medcost
Setting
Facility
Modifier
Global
Typical Low
$199.53
Median
$316.23
Typical High
$537.03
Medcost
Setting
Professional
Modifier
Global
Typical Low
$223.87
Median
$223.87
Typical High
$776.25
United
Setting
Facility
Modifier
Global
Typical Low
$363.08
Median
$891.25
Typical High
$2,089.30
United
Setting
Professional
Modifier
Global
Typical Low
$204.17
Median
$302.00
Typical High
$616.60
Wellcare
Setting
Facility
Modifier
Global
Typical Low
$1,995.26
Median
$1,995.26
Typical High
$28,840.32
Wellcare
Setting
Professional
Modifier
Global
Typical Low
$2,137.96
Median
$2,137.96
Typical High
$2,454.71

Where North Carolina 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.

North Carolina· 30th of 51

$355

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.