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New Jersey rates for HCPCS 40804

Removal of embedded foreign body, vestibule of mouth; simple

Facilitymedian $6,026 · 10th–90th $1,259–$11,2200%10%10th90th$6,026Professionalmedian $186 · 10th–90th $110–$3980%10%10th90th$186$20.0$100.0$500.0$2.0K$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
$354.81 / $6,456.54 / $11,748.98
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $181.97 / $380.19
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $245.47 / $602.56
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $245.47 / $398.11
Horizon BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,862.09 / $3,019.95 / $4,677.35
Horizon BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $213.80 / $478.63
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,137.96 / $5,128.61 / $8,511.38
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $177.83 / $371.54