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West Virginia rates for HCPCS 40804

Removal of embedded foreign body, vestibule of mouth; simple

Facilitymedian $178 · 10th–90th $107–$1,4130%20%10th90th$178Professionalmedian $174 · 10th–90th $105–$2750%10%20%10th90th$174$50.0$100.0$200.0$500.0$1.0K$2.0K

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
$107.15 / $177.83 / $1,412.54
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $173.78 / $229.09
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$123.03 / $123.03 / $147.91
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $128.82 / $128.82
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$34.67 / $199.53 / $199.53
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $208.93 / $933.25
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,230.27 / $1,230.27 / $2,511.89
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $165.96 / $309.03