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Indiana rates for HCPCS 40804

Removal of embedded foreign body, vestibule of mouth; simple

Facilitymedian $4,266 · 10th–90th $339–$8,3180%10%10th90th$4,266Professionalmedian $182 · 10th–90th $110–$3090%10%20%10th90th$182$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
$128.82 / $338.84 / $4,897.79
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $181.97 / $309.03
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,454.71 / $4,466.84 / $8,709.64
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $173.78 / $309.03
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$114.82 / $117.49 / $134.90
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $194.98 / $436.52
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$758.58 / $3,715.35 / $6,456.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $186.21 / $316.23