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
PROCEDURE ON MOUTH
Low
$1
Average
$599
Median
$151
High
$4.0k
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
46 payers; the 90th percentile is 108.7× the 10th. Each bar is a price range and its height is how many payers fall in it. Hover a bar, or a row in the ladder, for details.
Filter by billing methodology
Filter by billing class
| # | ||||||||
|---|---|---|---|---|---|---|---|---|
| 1 | Aetna fee schedule · outpatient · +24 other terms | 29 | $38 | $773 | $1.9k | 243% | — | $15 – $8.4k |
| 2 | Molina facility · case rate · outpatient · +15 other terms | 29 | $127 | $106 | $96 | 91% | — | $15 – $308 |
| 3 | UnitedHealthcare fee schedule · outpatient · +22 other terms | 28 | $29 | $57 | $58 | 101% | — | $2 – $358 |
| 4 | Blue Cross Blue Shield fee schedule · outpatient · +20 other terms | 24 | $75 | $85 | $58 | 68% | — | $0 – $391 |
| 5 | Humana professional · case rate · outpatient · +17 other terms | 19 | $21 | $21 | — | — | — | $21 – $21 |
| 6 | Regence professional · case rate · outpatient · +5 other terms | 17 | $21 | $21 | — | — | — | $21 – $21 |
| 7 | Anthem facility · case rate · outpatient · +15 other terms | 15 | $182 | $199 | $47 | 23% | — | $124 – $308 |
| 8 | Caresource facility · case rate · outpatient · +9 other terms | 15 | $185 | $199 | $46 | 23% | — | $124 – $314 |
| 9 | Optum facility · case rate · outpatient · +5 other terms | 13 | $164 | $161 | $74 | 46% | — | $14 – $279 |
| 10 | Cigna professional · other · outpatient · +22 other terms | 11 | $79 | $79 | $28 | 35% | — | $21 – $130 |
| 11 | Medicaid fee schedule · outpatient · +3 other terms | 10 | $391 | $391 | — | — | — | $391 – $391 |
| 12 | WellCare professional · fee schedule · both · +11 other terms | 10 | $15 | $17 | $13 | 78% | — | $0 – $57 |
| 13 | Amerihealth Caritas other · outpatient · +5 other terms | 9 | $256 | $434 | $1.1k | 248% | — | $15 – $3.8k |
| 14 | Kaiser fee schedule · outpatient · +5 other terms | 9 | $79 | $84 | $49 | 59% | — | $20 – $391 |
| 15 | Medica fee schedule · outpatient · +9 other terms | 9 | $4 | $51 | $91 | 176% | — | $2 – $410 |
| 16 | Aetna Better Health professional · fee schedule · both · +8 other terms | 8 | $10 | $11 | $9 | 81% | — | $0 – $21 |
| 17 | MultiPlan fee schedule · outpatient · +12 other terms | 8 | $5 | $103 | $140 | 136% | — | $5 – $410 |
| 18 | Bcbs Il professional · fee schedule · both · +2 other terms | 7 | $10 | $8 | $10 | 120% | — | $0 – $21 |
| 19 | Tricare other · outpatient · +7 other terms | 7 | $254 | $1.1k | $1.5k | 138% | — | $20 – $3.8k |
| 20 | Ambetter other · outpatient · +8 other terms | 6 | $262 | $1.4k | $1.6k | 115% | — | $254 – $3.8k |
| 21 | First Health professional · fee schedule · both · +6 other terms | 6 | $64 | $164 | $223 | 136% | — | $64 – $664 |
| 22 | Highmark other · outpatient · +7 other terms | 6 | $262 | $1.4k | $1.6k | 115% | — | $254 – $3.8k |
| 23 | Bcbs Mn fee schedule · outpatient · +2 other terms | 5 | $1 | $1 | $0 | 66% | — | $0 – $1 |
| 24 | Clover fee schedule · inpatient · +1 other terms | 5 | $22 | $22 | — | — | — | $22 – $22 |
| 25 | Medicare fee schedule · inpatient · +1 other terms | 5 | $20 | $20 | — | — | — | $20 – $20 |
← Hospitals reporting CPT 00170 · Snapshot 20261112T181611Z-3fa9fb76