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Mississippi rates for HCPCS 40804

Removal of embedded foreign body, vestibule of mouth; simple

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $1,819.70 / $2,818.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.71 / $181.97 / $363.08
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$416.87 / $416.87 / $1,412.54
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$245.47 / $245.47 / $245.47
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$229.09 / $229.09 / $229.09
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$117.49 / $181.97 / $295.12
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $32.36 / $33.11
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$630.96 / $1,513.56 / $3,162.28
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$117.49 / $213.80 / $416.87