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New Hampshire rates for HCPCS 40804

Removal of embedded foreign body, vestibule of mouth; simple

Facilitymedian $724 · 10th–90th $457–$9,7720%10%20%10th90th$724Professionalmedian $224 · 10th–90th $126–$4370%10%10th90th$224$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
$457.09 / $724.44 / $9,772.37
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $194.98 / $338.84
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,412.54 / $3,467.37
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $245.47 / $436.52
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $275.42 / $489.78
Harvard Pilgrim
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8,709.64 / $8,709.64 / $8,709.64
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $257.04 / $524.81
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8,709.64 / $8,709.64 / $8,709.64
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $275.42 / $524.81