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
PR UNLISTED PROCEDURE DENTOALVEOLAR STRUCTURES
Low
$0
Average
$3.7k
Median
$1.2k
High
$36.4k
Each hospital's average Anthem rate, under the methodology and billing class chosen below.
396 hospitals; the 90th percentile is 41.7× 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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698 hospital rates
iThe hospitals that file a Anthem 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 | Nationwide Children's Hospital Columbus, OH facility · percent of total billed charges · inpatientfrom % of charges | 1 | $268 | $479 | $494 | 103% | 490 | $29 – $2.0k |
| 2 | Nationwide Children's Hospital Columbus, OH facility · percent of total billed charges · outpatientfrom % of charges | 1 | $259 | $464 | $478 | 103% | 490 | $28 – $1.9k |
| 3 | Plymouth Medical Center Plymouth, IN facility · fee schedule · outpatient | 2 | $2.3k | $2.3k | — | — | 169–178 | $2.3k – $2.3k |
| 4 | Childrens Hospital Colorado Aurora, CO other · both | 2 | $7.9k | $7.9k | $209 | 3% | 147–156 | $7.7k – $8.2k |
| 5 | Childrens Hospital Colorado Aurora, CO percent of total billed charges · outpatientfrom % of charges | 2 | $278 | $278 | $6 | 2% | 147–156 | $272 – $284 |
| 6 | Mishawaka Medical Center Mishawaka, IN facility · fee schedule · outpatient | 2 | $2.3k | $2.3k | — | — | 111–120 | $2.3k – $2.3k |
| 7 | St Clare Memorial Hospital Inc OCONTO FALLS, WI fee schedule · outpatient | 1 | $2.3k | $2.3k | — | — | 80 | $2.3k – $2.3k |
| 8 | La Porte Hospital Company LLC La Porte, IN facility · other · outpatient | 2 | $1.3k | $1.3k | $1.0k | 80% | 46 | $251 – $2.3k |
| 9 | Columbus Regional Hospital Columbus, IN fee schedule · both | 1 | $2.3k | $2.3k | — | — | 32 | $2.3k – $2.3k |
| 10 | Columbus Regional Hospital Columbus, IN fee schedule · outpatient | 1 | $2.3k | $2.3k | — | — | 32 | $2.3k – $2.3k |
| 11 | Columbus Regional Hospital Columbus, IN percent of total billed charges · bothfrom % of charges | 2 | $306 | $306 | $7 | 2% | 29 | $299 – $313 |
| 12 | Columbus Regional Hospital Columbus, IN percent of total billed charges · outpatientfrom % of charges | 1 | $5.7k | $5.7k | — | — | 29 | $5.7k – $5.7k |
| 13 | IOM Health System LP Fort Wayne, IN facility · other · outpatient | 3 | $401 | $975 | $920 | 94% | 29 | $251 – $2.3k |
| 14 | University of Virginia Medical Center Charlottesville, VA other · both | 2 | $710 | $652 | $82 | 13% | 24–42 | $536 – $710 |
| 15 | University of Virginia Medical Center Charlottesville, VA other · outpatient | 3 | $623 | $548 | $193 | 35% | 24–42 | $238 – $710 |
| 16 | Inova Fair Oaks Hospital Fairfax, VA fee schedule · both | 5 | $628 | $768 | $540 | 70% | 23–32 | $232 – $1.8k |
| 17 | St. Vincent Carmel Hospital, Inc. Carmel, IN percent of total billed charges · bothfrom % of charges | 2 | $3.6k | $3.6k | $330 | 9% | 21–30 | $3.3k – $3.9k |
| 18 | Cleveland Clinic Mercy Hospital Canton, OH facility · percent of total billed charges · outpatientfrom % of charges | 4 | $150 | $148 | $13 | 9% | 18 | $127 – $168 |
| 19 | Inova Loudoun Hospital Leesburg, VA fee schedule · both | 5 | $625 | $766 | $540 | 70% | 15–33 | $232 – $1.8k |
| 20 | The Medical Center of Central Georgia Inc Macon, GA other · outpatient | 1 | $8.8k | $8.8k | — | — | 15 | $8.8k – $8.8k |
| 21 | HARTFORD HOSPITAL HARTFORD, CT percent of total billed charges · outpatientfrom % of charges | 2 | $8.3k | $8.3k | $2.3k | 27% | 13–22 | $6.1k – $10.6k |
| 22 | St. Joseph Health System, LLC Wayne, IN facility · other · outpatient | 3 | $401 | $975 | $920 | 94% | 12 | $251 – $2.3k |
| 23 | HOSPITAL OF CENTRAL CONNECTICUT AT NEW BRITAIN D/B/A THE HOSPITAL OF CENTRAL CONNECTICUT SOUTHINGTON, CT percent of total billed charges · outpatientfrom % of charges | 1 | $14.9k | $14.9k | — | — | 11 | $14.9k – $14.9k |
| 24 | MaineHealth Portland, ME other · both | 1 | $1.0k | $1.0k | — | — | 4–40 | $1.0k – $1.0k |
| 25 | ST VINCENT HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST FRANCIS Oconto Falls, WI case rate · outpatient | 2 | $15.2k | $15.2k | $280 | 2% | 4–40 | $15.0k – $15.5k |
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