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Pennsylvania rates for HCPCS 40805

Removal of embedded foreign body, vestibule of mouth; complicated

Facilitymedian $3,802 · 10th–90th $724–$8,3180%10%10th90th$3,802Professionalmedian $282 · 10th–90th $195–$5620%20%10th90th$282$10.0$50.0$200.0$1.0K$5.0K$20.0K

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
$954.99 / $3,890.45 / $8,317.64
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $275.42 / $602.56
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,630.27 / $2,691.53 / $57,543.99
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $302.00 / $302.00
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $316.23 / $489.78
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$478.63 / $478.63 / $489.78
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $354.81 / $537.03
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$724.44 / $2,570.40 / $8,317.64
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $275.42 / $549.54
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $512.86 / $831.76
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$190.55 / $346.74 / $416.87
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $295.12 / $416.87
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$363.08 / $1,202.26 / $3,890.45
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $288.40 / $501.19