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Washington, DC rates for HCPCS 40804

Removal of embedded foreign body, vestibule of mouth; simple

Facilitymedian $1,698 · 10th–90th $135–$7,7620%10%10th90th$1,698Professionalmedian $214 · 10th–90th $132–$3800%10%20%10th90th$214$100.0$500.0$2.0K$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
$134.90 / $1,698.24 / $7,762.47
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $213.80 / $371.54
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $2,238.72 / $6,456.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $218.78 / $489.78
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $239.88 / $446.68
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,023.29 / $3,981.07 / $25,118.86
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $239.88 / $501.19