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Alabama rates for HCPCS 40804

Removal of embedded foreign body, vestibule of mouth; simple

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,096.48 / $1,445.44 / $2,398.83
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$109.65 / $186.21 / $363.08
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$151.36 / $181.97 / $245.47
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.18 / $151.36 / $239.88
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$107.15 / $186.21 / $398.11
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$645.65 / $1,659.59 / $3,090.30
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$95.50 / $162.18 / $281.84