go back

South Carolina rates for HCPCS 40804

Removal of embedded foreign body, vestibule of mouth; simple

Facilitymedian $269 · 10th–90th $123–$9,1200%5%10th90th$269Professionalmedian $182 · 10th–90th $107–$2880%10%10th90th$182$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
$131.83 / $7,943.28 / $16,595.87
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $181.97 / $288.40
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$87.10 / $154.88 / $269.15
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $154.88 / $239.88
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $208.93 / $363.08
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$114.82 / $204.17 / $416.87
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $32.36 / $33.11
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$724.44 / $4,897.79 / $9,772.37
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $190.55 / $331.13