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Missouri rates for HCPCS 40804

Removal of embedded foreign body, vestibule of mouth; simple

Facilitymedian $2,042 · 10th–90th $263–$5,6230%5%10th90th$2,042Professionalmedian $182 · 10th–90th $110–$3310%10%10th90th$182$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
$173.78 / $4,265.80 / $8,511.38
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
$676.08 / $1,819.70 / $4,168.69
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $190.55 / $309.03
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $208.93 / $295.12
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $223.87 / $407.38
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $251.19 / $2,630.27
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $380.19 / $1,412.54
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$724.44 / $1,148.15 / $2,818.38
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $223.87 / $389.05