go back

North Dakota rates for HCPCS 40804

Removal of embedded foreign body, vestibule of mouth; simple

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$119.00 / $199.84 / $8,500.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$108.53 / $183.89 / $199.84
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$236.05 / $304.47 / $470.48
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$158.74 / $311.56 / $623.42
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$119.00 / $199.84 / $357.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$206.40 / $366.61 / $523.42
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$203.18 / $375.28 / $523.42