go back

Drainage Of A Complicated Mouth Lining Infection

New Jersey 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?

$316

Typical negotiated rate. In New Jersey, July 2026.

Insurers have agreed to pay about $316 for this service. The price depends on where it is billed: about $295 from a physician practice, and about $5,888 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 5 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$295$204 to $398
FacilityA hospital or hospital-owned outpatient department$5,888$3,981 to $7,762

How much rates vary

Facilitymedian $5,888 · 10th to 90th $537 to $10,471Professionalmedian $295 · 10th to 90th $191 to $813
$200$500$1K$2K$5K$10Kfacility $5,888professional $295

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
$524.81
Median
$6,025.60
Typical High
$10,715.19
Aetna
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$281.84
Typical High
$4,466.84
Cigna
Setting
Professional
Modifier
Global
Typical Low
$204.17
Median
$380.19
Typical High
$776.25
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$323.59
Median
$363.08
Typical High
$588.84
Horizon BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,122.02
Median
$1,621.81
Typical High
$2,570.40
Horizon BCBS
Setting
Professional
Modifier
Global
Typical Low
$169.82
Median
$323.59
Typical High
$741.31
United
Setting
Facility
Modifier
Global
Typical Low
$1,174.90
Median
$2,754.23
Typical High
$6,760.83
United
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$275.42
Typical High
$588.84

Where New Jersey 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.

New Jersey· 40th of 51

$316

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.