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Drainage Of A Complicated Mouth Lining Infection

New York 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?

$447

Typical negotiated rate. In New York, July 2026.

Insurers have agreed to pay about $447 for this service. The price depends on where it is billed: about $309 from a physician practice, and about $3,236 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 9 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$309$240 to $468
FacilityA hospital or hospital-owned outpatient department$3,236$1,622 to $4,898

How much rates vary

Facilitymedian $3,236 · 10th to 90th $316 to $7,586Professionalmedian $309 · 10th to 90th $204 to $794
$200$500$1K$2K$5K$10Kfacility $3,236professional $309

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
$275.42
Median
$2,951.21
Typical High
$7,762.47
Aetna
Setting
Professional
Modifier
Global
Typical Low
$204.17
Median
$309.03
Typical High
$812.83
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,819.70
Median
$3,630.78
Typical High
$5,011.87
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$199.53
Median
$257.04
Typical High
$794.33
CDPHP
Setting
Facility
Modifier
Global
Typical Low
$281.84
Median
$1,698.24
Typical High
$6,165.95
CDPHP
Setting
Professional
Modifier
Global
Typical Low
$281.84
Median
$281.84
Typical High
$416.87
Cigna
Setting
Facility
Modifier
Global
Typical Low
$331.13
Median
$331.13
Typical High
$5,011.87
Cigna
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$489.78
Typical High
$1,122.02
Emblem Health
Setting
Facility
Modifier
Global
Typical Low
$64.57
Median
$218.78
Typical High
$501.19
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$323.59
Median
$446.68
Typical High
$630.96
Excellus BCBS
Setting
Professional
Modifier
Global
Typical Low
$245.47
Median
$389.05
Typical High
$724.44
MVP Health Care
Setting
Facility
Modifier
Global
Typical Low
$223.87
Median
$50,118.72
Typical High
$75,857.76
MVP Health Care
Setting
Professional
Modifier
Global
Typical Low
$338.84
Median
$416.87
Typical High
$758.58
United
Setting
Facility
Modifier
Global
Typical Low
$1,258.93
Median
$2,511.89
Typical High
$4,897.79
United
Setting
Professional
Modifier
Global
Typical Low
$181.97
Median
$346.74
Typical High
$691.83
Univera
Setting
Facility
Modifier
Global
Typical Low
$162.18
Median
$239.88
Typical High
$812.83
Univera
Setting
Professional
Modifier
Global
Typical Low
$239.88
Median
$380.19
Typical High
$691.83

Where New York 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 York· 14th of 51

$447

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.