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Draining An Abscess In The Roof Of The Mouth

Maine rates for HCPCS 42000

Opens and drains a pocket of pus, fluid or blood in the roof of the mouth or in the uvula, the small flap that hangs at the back of the throat. A cut is made through the lining, the collection is emptied and the area is rinsed out. It relieves pain, pressure and swelling that can make swallowing difficult.

Rates data updated July 2026.

How much does Draining An Abscess In The Roof Of The Mouth cost?

$191

Typical physician fee. In Maine, July 2026.

Insurers have agreed to pay about $191 for this service. Most negotiated rates run $132 to $245.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 6 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $617 · 10th to 90th $617 to $617Professionalmedian $191 · 10th to 90th $120 to $363
$100$200$500facility $617professional $191

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$158.49
Typical High
$190.55
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$181.97
Typical High
$331.13
Cigna
Setting
Facility
Modifier
Global
Typical Low
$616.60
Median
$616.60
Typical High
$616.60
Cigna
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$194.98
Typical High
$389.05
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$218.78
Typical High
$416.87
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$165.96
Typical High
$239.88
United
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$199.53
Typical High
$354.81

Where Maine sits

The same service costs 2.2 times more in Minnesota than in West Virginia. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Maine· 12th of 51

$191

MN $302WV $138

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.