Removal of foreign object from mouth at TMC Bonham Hospital

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.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

FB REM MOUTH-EMBEDED 450

Bonham, TX

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Pricing by billing methodology

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How this price compares nationally

TMC Bonham Hospital’s median price of $151 is 85% below the median hospital's median price ($996), higher than 7% of the 1,881 hospitals reporting CPT 40804. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting CPT 40804 at TMC Bonham Hospital

Negotiated rates from the hospital’s own file: 8 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.

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#
1	Blue Cross Blue Shield qhp case rate · both	$30	$30	—	—	—	$30 – $30
2	Blue Cross Blue Shield hmo case rate · both	$58	$58	—	—	—	$58 – $58
3	Blue Cross Blue Shield managed_care case rate · both	$58	$58	—	—	—	$58 – $58
4	Blue Cross Blue Shield ppo case rate · both	$58	$58	—	—	—	$58 – $58
5	Aetna medicare percent of total billed charges · bothfrom % of charges	$104	$104	—	—	—	$104 – $104
6	Humana medicare percent of total billed charges · bothfrom % of charges	$104	$104	—	—	—	$104 – $104
7	UnitedHealthcare medicare percent of total billed charges · bothfrom % of charges	$104	$104	—	—	—	$104 – $104
8	Superior Healthplan medicaid percent of total billed charges · bothfrom % of charges	$149	$149	$5	3%	—	$144 – $154
9	UnitedHealthcare medicaid percent of total billed charges · bothfrom % of charges	$149	$149	$5	3%	—	$144 – $154
10	Molina medicaid percent of total billed charges · bothfrom % of charges	$168	$159	$22	14%	—	$128 – $179
11	Ambetter qhp percent of total billed charges · bothfrom % of charges	$163	$163	—	—	—	$163 – $163
12	Cigna hmo percent of total billed charges · bothfrom % of charges	$192	$192	—	—	—	$192 – $192
13	UnitedHealthcare managed_care case rate · both	$1k	$1k	—	—	—	$1k – $1k
14	Aetna ppo case rate · both	$1.2k	$1.2k	—	—	—	$1.2k – $1.2k

Last updated: Sep 1, 2026

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