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North Carolina rates for HCPCS 40804

Removal of embedded foreign body, vestibule of mouth; simple

Facilitymedian $282 · 10th–90th $110–$3,2360%10%20%10th90th$282Professionalmedian $195 · 10th–90th $112–$3890%10%20%10th90th$195$100.0$200.0$500.0$1.0K$2.0K$5.0K$10.0K

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
$109.65 / $288.40 / $3,235.94
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $181.97 / $363.08
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $281.84 / $549.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $234.42 / $398.11
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$112.20 / $194.98 / $338.84
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $89.13 / $512.86
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,230.27 / $3,890.45 / $6,760.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $204.17 / $398.11
Wellcare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$56.23 / $1,288.25 / $1,288.25
Wellcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,412.54 / $1,412.54 / $1,659.59