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Tennessee rates for HCPCS 40804

Removal of embedded foreign body, vestibule of mouth; simple

Facilitymedian $2,399 · 10th–90th $1,023–$4,2660%10%20%10th90th$2,399Professionalmedian $182 · 10th–90th $110–$3470%10%10th90th$182$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
$524.81 / $2,691.53 / $7,585.78
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $181.97 / $309.03
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,023.29 / $2,187.76 / $2,951.21
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $229.09 / $389.05
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $199.53 / $354.81
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $1,288.25 / $1,288.25
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,412.54 / $1,659.59 / $1,659.59
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,122.02 / $2,187.76 / $3,981.07
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $208.93 / $380.19