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Minnesota rates for HCPCS 40804

Removal of embedded foreign body, vestibule of mouth; simple

Facilitymedian $794 · 10th–90th $182–$3,4670%5%10%10th90th$794Professionalmedian $309 · 10th–90th $145–$7080%5%10%10th90th$309$50.0$100.0$200.0$500.0$1.0K$2.0K$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
$107.15 / $181.97 / $181.97
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $181.97 / $309.03
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$275.42 / $1,778.28 / $4,265.80
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $363.08 / $707.95
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$489.78 / $724.44 / $1,698.24
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $501.19 / $851.14
Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$575.44 / $707.95 / $1,412.54
Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $446.68 / $794.33
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$162.18 / $295.12 / $3,311.31
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $426.58 / $1,380.38
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,584.89 / $3,235.94 / $6,309.57
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $338.84 / $707.95