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Idaho rates for HCPCS 40804

Removal of embedded foreign body, vestibule of mouth; simple

Facilitymedian $646 · 10th–90th $117–$6,1660%5%10%10th90th$646Professionalmedian $224 · 10th–90th $115–$4070%10%10th90th$224$50.0$200.0$1.0K$5.0K

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
$389.05 / $5,495.41 / $10,471.29
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $186.21 / $436.52
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$48.98 / $208.93 / $2,344.23
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $295.12 / $389.05
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $218.78 / $331.13
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$120.23 / $269.15 / $691.83
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $234.42 / $416.87
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $32.36 / $33.11
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,318.26 / $1,819.70 / $2,884.03
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $251.19 / $398.11
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $199.53 / $1,698.24
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,467.37 / $6,165.95 / $7,762.47
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $208.93 / $363.08