go back

Montana rates for HCPCS 40804

Removal of embedded foreign body, vestibule of mouth; simple

Facilitymedian $316 · 10th–90th $195–$3980%20%40%10th90th$316Professionalmedian $219 · 10th–90th $120–$5500%10%20%10th90th$219$100.0$500.0$2.0K$10.0K$50.0K

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
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $204.17 / $549.54
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$46,773.51 / $75,857.76 / $95,499.26
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $181.97 / $302.00
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$181.97 / $181.97 / $181.97
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $208.93 / $302.00
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$199.53 / $316.23 / $371.54
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $316.23 / $371.54
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$114.82 / $208.93 / $389.05
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $181.97 / $380.19
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$263.03 / $263.03 / $263.03
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $281.84 / $478.63