Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
HC REM F/B MOUTH SQ
DeKalb, MS
See all hospitals reporting CPT 40804 →Price type
Kemper CAH, Inc.’s median price of $745 is 25% below the median hospital's median price ($995), higher than 26% of the 1,897 hospitals reporting CPT 40804. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 11 payers, 14 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
Filter by billing methodology
Filter by billing class
| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | Humana all payor percent of total billed charges · outpatientfrom % of charges | $390 | $390 | $314 | 80% | — | $77 – $704 |
| 2 | Optum all payor other · outpatient | $491 | $491 | $394 | 80% | — | $96 – $885 |
| 3 | UnitedHealthcare all payor other · outpatient | $491 | $491 | $394 | 80% | — | $96 – $885 |
| 4 | Cigna all payor percent of total billed charges · outpatientfrom % of charges | $549 | $549 | $441 | 80% | — | $108 – $991 |
| 5 | Cigna Healthspring all payor other · outpatient | $577 | $577 | $464 | 80% | — | $113 – $1.0k |
| 6 | Humana all payor other · outpatient | $577 | $577 | $464 | 80% | — | $113 – $1.0k |
| 7 | Ambetter all payor other · outpatient | $583 | $583 | $468 | 80% | — | $115 – $1.1k |
| 8 | Molina all payor other · outpatient | $583 | $583 | $468 | 80% | — | $115 – $1.1k |
| 9 | WellCare all payor other · outpatient | $583 | $583 | $468 | 80% | — | $115 – $1.1k |
| 10 | Aetna all payor other · outpatient | $625 | $625 | $502 | 80% | — | $123 – $1.1k |
| 11 | Molina all payor fee schedule · outpatient | $672 | $672 | — | — | — | $672 – $672 |
| 12 | MultiPlan all payor percent of total billed charges · outpatientfrom % of charges | $721 | $721 | $580 | 80% | — | $142 – $1.3k |
| 13 | Bcbs Ms all payor fee schedule · outpatient | $745 | $745 | — | — | — | $745 – $745 |
| 14 | UnitedHealthcare all payor case rate · outpatient | $1.2k | $1.2k | — | — | — | $1.2k – $1.2k |
Last updated: Apr 1, 2026
See Removal of foreign object from mouth pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.