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Removal Of Foreign Object From Mouth Lining

Connecticut rates for HCPCS 40804

This service removes an object that has become lodged in the soft tissue lining the inside of the lips or cheeks, known as the vestibule of the mouth. It covers a straightforward removal that does not require extensive surgical work to reach or extract the object. The area is examined and the material is taken out, often under local anesthesia.

Rates data updated July 2026.

How much does Removal Of Foreign Object From Mouth Lining cost?

$275

Typical negotiated rate. In Connecticut, July 2026.

Insurers have agreed to pay about $275 for this service. The price depends on where it is billed: about $263 from a physician practice, and about $5,248 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$263$174 to $389
FacilityA hospital or hospital-owned outpatient department$5,248$3,162 to $7,943

How much rates vary

Facilitymedian $5,248 · 10th to 90th $389 to $10,471Professionalmedian $263 · 10th to 90th $132 to $525
$100$200$500$1K$2K$5K$10Kfacility $5,248professional $263

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
$389.05
Median
$5,248.07
Typical High
$10,471.29
Aetna
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$223.87
Typical High
$524.81
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$2,137.96
Median
$3,162.28
Typical High
$10,471.29
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$331.13
Typical High
$537.03
Cigna
Setting
Facility
Modifier
Global
Typical Low
$50.12
Median
$50.12
Typical High
$50.12
Cigna
Setting
Professional
Modifier
Global
Typical Low
$158.49
Median
$275.42
Typical High
$489.78
ConnectiCare
Setting
Professional
Modifier
Global
Typical Low
$346.74
Median
$346.74
Typical High
$416.87
United
Setting
Facility
Modifier
Global
Typical Low
$3,715.35
Median
$6,025.60
Typical High
$9,332.54
United
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$245.47
Typical High
$512.86

Where Connecticut sits

The same service costs 8.9 times more in California than in Kentucky. 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.

Connecticut· 12th of 51

$275

CA $1,549KY $174

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.