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Alaska rates for HCPCS 40804

Removal of embedded foreign body, vestibule of mouth; simple

Facilitymedian $282 · 10th–90th $148–$1,3180%5%10th90th$282Professionalmedian $200 · 10th–90th $110–$7080%10%10th90th$200$100.0$200.0$500.0$1.0K$2.0K$5.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$331.13 / $9,772.37 / $16,595.87
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $181.97 / $537.03
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $169.82 / $380.19
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$138.04 / $263.03 / $933.25
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $588.84 / $1,202.26
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$467.74 / $776.25 / $1,071.52
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$138.04 / $263.03 / $933.25
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $257.04 / $426.58
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $380.19 / $1,000.00