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Drainage Of A Complicated Mouth Lining Infection

South Dakota 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?

$427

Typical negotiated rate. In South Dakota, July 2026.

Insurers have agreed to pay about $427 for this service. The price depends on where it is billed: about $427 from a physician practice, and about $479 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$427$282 to $575
FacilityA hospital or hospital-owned outpatient department$479$302 to $3,090

How much rates vary

Facilitymedian $479 · 10th to 90th $245 to $4,365Professionalmedian $427 · 10th to 90th $191 to $708
$200$500$1K$2Kfacility $479professional $427

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
$208.93
Median
$3,090.30
Typical High
$4,365.16
Aetna
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$257.04
Typical High
$281.84
Cigna
Setting
Professional
Modifier
Global
Typical Low
$478.63
Median
$602.56
Typical High
$870.96
Medica
Setting
Facility
Modifier
Global
Typical Low
$245.47
Median
$389.05
Typical High
$831.76
Medica
Setting
Professional
Modifier
Global
Typical Low
$263.03
Median
$575.44
Typical High
$2,187.76
Midlands
Setting
Professional
Modifier
Global
Typical Low
$446.68
Median
$501.19
Typical High
$707.95
Midlands
Setting
Professional
Modifier
Global
Typical Low
$426.58
Median
$426.58
Typical High
$616.60
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$295.12
Median
$426.58
Typical High
$575.44
United
Setting
Facility
Modifier
Global
Typical Low
$812.83
Median
$812.83
Typical High
$812.83
United
Setting
Professional
Modifier
Global
Typical Low
$263.03
Median
$467.74
Typical High
$812.83
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$416.87
Median
$478.63
Typical High
$776.25

Where South Dakota 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.

South Dakota· 17th of 51

$427

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.