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
PR IMPRESS&CUST ORAL SURG SPLINT
Low
$0
Average
$4.4k
Median
$2.2k
High
$33.7k
Each hospital's average Cigna rate, under the methodology and billing class chosen below.
673 hospitals; the 90th percentile is 47.3× the 10th. Each bar is a price range and its height is how many hospitals fall in it. Hover a bar, or a row in the ladder, for details.
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800 hospital rates
iThe hospitals that file a Cigna rate for this code, one row per hospital and set of terms (billing class, payment method, setting). Rates under different terms are never blended, so the terms are shown under each hospital’s name. Figures are the hospital’s averages across its plans.| # | Plans | |||||||
|---|---|---|---|---|---|---|---|---|
| 1 | Massachusetts General Hospital Boston, MA percent of total billed charges · bothfrom % of charges | 2 | $2.9k | $2.9k | $570 | 20% | 2–20 | $2.3k – $3.5k |
| 2 | Arkansas Childrens Hospital Little Rock, AR facility · percent of total billed charges · outpatientfrom % of charges | 1 | $4.4k | $4.4k | — | — | 1–10 | $4.4k – $4.4k |
| 3 | Boston Medical Center Boston, MA percent of total billed charges · bothfrom % of charges | 1 | $1.1k | $1.1k | — | — | 1–10 | $1.1k – $1.1k |
| 4 | Mayo Clinic Rochester, MN facility · percent of total billed charges · outpatientfrom % of charges | 1 | $12.0k | $12.0k | — | — | 1–10 | $12.0k – $12.0k |
| 5 | SOUTH MIAMI HOSPITAL Weston, FL percent of total billed charges · outpatientfrom % of charges | 1 | $6.1k | $6.1k | — | — | 1–10 | $6.1k – $6.1k |
| 6 | The Cleveland Clinic Foundation Brunswick, OH facility · percent of total billed charges · outpatientfrom % of charges | 3 | $792 | $723 | $144 | 20% | 1–10 | $523 – $854 |
| 7 | ACADIA GENERAL HOSPITAL, INC 1305 CROWLEY RAYNE HWY case rate · outpatient | 1 | $1.8k | $1.8k | — | — | — | $1.8k – $1.8k |
| 8 | AKRON GENERAL MEDICAL CENTER Akron, OH facility · fee schedule · outpatient | 1 | $231 | $231 | — | — | — | $231 – $231 |
| 9 | AKRON GENERAL MEDICAL CENTER Akron, OH professional · fee schedule · outpatient | 2 | $907 | $907 | $76 | 8% | — | $832 – $983 |
| 10 | ALBANY MEDICAL CENTER HOSPITAL Albany, NY professional · fee schedule · outpatient | 4 | $925 | $939 | $169 | 18% | — | $720 – $1.2k |
| 11 | ALLE-KISKI MEDICAL CENTER NATRONA HEIGHTS, PA fee schedule · inpatient | 1 | $772 | $772 | — | — | — | $772 – $772 |
| 12 | ALLE-KISKI MEDICAL CENTER NATRONA HEIGHTS, PA fee schedule · outpatient | 2 | $636 | $549 | $226 | 41% | — | $239 – $772 |
| 13 | ARTHUR G JAMES CANCER HOSPITAL AND RESEARCH INSTITUTE Columbus, OH case rate · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 14 | ATHOL MEMORIAL HOSPITAL INCORPORATED Athol, MA case rate · outpatient | 1 | $1.1k | $1.1k | — | — | — | $1.1k – $1.1k |
| 15 | AdventHealth Avista Louisville, CO fee schedule · outpatient | 3 | $4.0k | $2.9k | $1.8k | 64% | — | $258 – $4.3k |
| 16 | AdventHealth Castle Rock Castle Rock, CO fee schedule · outpatient | 3 | $4.0k | $2.9k | $1.8k | 65% | — | $255 – $4.3k |
| 17 | AdventHealth Littleton Littleton, CO fee schedule · outpatient | 3 | $4.0k | $2.9k | $1.8k | 65% | — | $255 – $4.3k |
| 18 | AdventHealth Parker Aurora, CO fee schedule · outpatient | 3 | $4.0k | $2.9k | $1.8k | 65% | — | $255 – $4.3k |
| 19 | AdventHealth Porter Denver, CO fee schedule · outpatient | 3 | $4.0k | $2.9k | $1.8k | 65% | — | $255 – $4.3k |
| 20 | Adventhealth Gordon Calhoun, GA fee schedule · outpatient | 1 | $236 | $236 | — | — | — | $236 – $236 |
| 21 | Adventhealth Murray Chatsworth, GA fee schedule · outpatient | 1 | $221 | $221 | — | — | — | $221 – $221 |
| 22 | Adventhealth Ottawa Ottawa, KS fee schedule · outpatient | 2 | $3.4k | $3.4k | $122 | 4% | — | $3.2k – $3.5k |
| 23 | Adventhealth Shawnee Mission Lenexa, KS fee schedule · outpatient | 2 | $3.4k | $3.4k | $122 | 4% | — | $3.2k – $3.5k |
| 24 | Adventhealth South Overland Park Overland Park, KS fee schedule · outpatient | 2 | $3.4k | $3.4k | $122 | 4% | — | $3.2k – $3.5k |
| 25 | Albert Einstein Medical Center Philadelphia, PA fee schedule · outpatient | 2 | $4.6k | $4.6k | $4.4k | 95% | — | $246 – $9.0k |
← Payers reporting CPT 21085 · Snapshot 20261112T181611Z-3fa9fb76