APC 5871

Dental Procedures

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.

Generation details were not recorded for this description.

Original text from hospital filings

Dental Procedures

Payers reporting APC 5871

Payer pricing summary

Low

$571

Average

$1.8k

Median

$1.3k

High

$5.7k

Payer rate distribution

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#
1	Caresource other · outpatient · +2 other terms	7	$2.0k	$2.2k	$1.1k	51%	42–96	$646 – $4.1k
2	Excellus case rate · outpatient · +1 other terms	5	$1.8k	$1.8k	$473	26%	26–44	$1.1k – $2.7k
3	Phcs facility · percent of total billed charges · outpatientfrom % of charges	1	$5.7k	$5.7k	—	—	1–10	$5.7k – $5.7k
4	UnitedHealthcare fee schedule · outpatient · +6 other terms	175	$670	$751	$292	39%	—	$576 – $1.7k
5	Humana fee schedule · outpatient · +6 other terms	162	$659	$734	$290	40%	—	$567 – $2.7k
6	Aetna fee schedule · outpatient · +5 other terms	156	$675	$834	$479	57%	—	$573 – $2.9k
7	WellCare fee schedule · outpatient · +4 other terms	132	$669	$692	$148	21%	—	$579 – $1.7k
8	Blue Cross Blue Shield fee schedule · outpatient · +8 other terms	127	$689	$847	$464	55%	—	$567 – $4.9k
9	Devoted fee schedule · outpatient · +3 other terms	122	$649	$650	$18	3%	—	$567 – $682
10	Cigna Healthspring fee schedule · outpatient · +1 other terms	110	$682	$668	$28	4%	—	$649 – $722
11	Molina fee schedule · outpatient · +5 other terms	69	$1.0k	$1.1k	$460	43%	—	$613 – $2.5k
12	Superior Healthplan fee schedule · outpatient	40	$682	$682	$0	0%	—	$682 – $683
13	Anthem fee schedule · outpatient · +2 other terms	31	$682	$887	$407	46%	—	$614 – $1.7k
14	Oscar fee schedule · outpatient · +2 other terms	28	$673	$1.2k	$1.2k	99%	—	$636 – $4.6k
15	Amerihealth Caritas fee schedule · outpatient	17	$810	$791	$40	5%	—	$704 – $810
16	Cigna fee schedule · outpatient · +4 other terms	16	$660	$1.4k	$913	65%	—	$624 – $3.6k
17	Clover fee schedule · outpatient · +2 other terms	15	$682	$654	$32	5%	—	$596 – $682
18	Kaiser fee schedule · outpatient · +4 other terms	15	$696	$820	$331	40%	—	$682 – $1.7k
19	Ambetter facility · fee schedule · outpatient · +4 other terms	14	$971	$1.8k	$2.0k	109%	—	$668 – $9.1k
20	Optum facility · fee schedule · outpatient · +3 other terms	14	$656	$614	$33	5%	—	$574 – $727
21	Tricare facility · fee schedule · outpatient · +1 other terms	12	$727	$1.1k	$487	45%	—	$639 – $1.7k
22	Highmark facility · fee schedule · outpatient · +2 other terms	10	$1.2k	$1.2k	$468	40%	—	$648 – $1.9k
23	Medicare case rate · outpatient · +1 other terms	8	$1.5k	$1.5k	$36	2%	—	$1.5k – $1.6k
24	Sanford Health Plan case rate · outpatient	3	$2.4k	$2.4k	$246	10%	—	$2.0k – $2.8k
25	Aetna Better Health facility · case rate · outpatient	1	$1.3k	$1.3k	$413	32%	—	$870 – $1.7k

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