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Maryland rates for HCPCS 40804

Removal of embedded foreign body, vestibule of mouth; simple

Facilitymedian $708 · 10th–90th $708–$7080%50%100%$708Professionalmedian $186 · 10th–90th $112–$3800%10%10th90th$186$100.0$200.0$500.0$1.0K$2.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $186.21 / $380.19
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $138.04 / $158.49
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $213.80 / $380.19
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $257.04 / $363.08
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$707.95 / $707.95 / $707.95
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $194.98 / $346.74
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $288.40 / $323.59