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
Sialot Submndblr Sublngl/Prtd Uncomp Intraoral
Low
$208
Average
$3.1k
Median
$2.8k
High
$14.8k
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
67 payers; the 90th percentile is 6.3× 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.
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| # | ||||||||
|---|---|---|---|---|---|---|---|---|
| 1 | Aetna fee schedule · outpatient · +31 other terms | 471 | $3.3k | $3.5k | $2.7k | 78% | 2–20 | $14 – $22.2k |
| 2 | UnitedHealthcare fee schedule · outpatient · +33 other terms | 536 | $3.1k | $2.8k | $4.6k | 166% | 1–10 | $1 – $95.3k |
| 3 | Blue Cross Blue Shield fee schedule · outpatient · +30 other terms | 356 | $3.3k | $3.2k | $4.2k | 131% | — | $1 – $24.3k |
| 4 | Humana fee schedule · outpatient · +24 other terms | 352 | $3.2k | $2.3k | $1.7k | 73% | — | $1 – $12.8k |
| 5 | Cigna case rate · outpatient · +27 other terms | 241 | $6.8k | $12.2k | $8.8k | 72% | — | $1 – $40.7k |
| 6 | Molina fee schedule · outpatient · +23 other terms | 221 | $914 | $1.3k | $2.0k | 156% | — | $1 – $12.3k |
| 7 | WellCare fee schedule · outpatient · +16 other terms | 174 | $3.3k | $3.1k | $1.5k | 50% | — | $128 – $7.6k |
| 8 | Oscar case rate · outpatient · +19 other terms | 137 | $4.0k | $3.1k | $1.5k | 47% | — | $1.4k – $7.5k |
| 9 | Anthem fee schedule · outpatient · +26 other terms | 124 | $2.0k | $2.2k | $4.1k | 187% | — | $94 – $24.3k |
| 10 | Kaiser fee schedule · outpatient · +20 other terms | 100 | $4.1k | $4.5k | $4.1k | 91% | — | $55 – $22.4k |
| 11 | Ambetter fee schedule · outpatient · +13 other terms | 78 | $5.8k | $4.5k | $2.9k | 65% | — | $147 – $10.8k |
| 12 | Healthcare Highways case rate · outpatient · +2 other terms | 76 | $2.7k | $2.7k | $571 | 21% | — | $2k – $4.3k |
| 13 | Aetna Better Health fee schedule · outpatient · +16 other terms | 72 | $154 | $344 | $615 | 178% | — | $123 – $3.4k |
| 14 | Devoted fee schedule · outpatient · +14 other terms | 69 | $3.3k | $2.9k | $1.1k | 39% | — | $159 – $3.7k |
| 15 | Caresource fee schedule · outpatient · +12 other terms | 56 | $2.0k | $1.7k | $1.7k | 98% | — | $100 – $5.7k |
| 16 | MultiPlan fee schedule · outpatient · +20 other terms | 44 | $3.9k | $4.7k | $1.2k | 26% | — | $106 – $5.2k |
| 17 | Optum fee schedule · outpatient · +21 other terms | 42 | $3.0k | $3.1k | $3.0k | 97% | — | $148 – $12.2k |
| 18 | Superior Healthplan case rate · outpatient · +4 other terms | 38 | $948 | $1.0k | $539 | 53% | — | $929 – $4.9k |
| 19 | Bcbs Tx fee schedule · outpatient · +3 other terms | 33 | $611 | $580 | $968 | 167% | — | $115 – $3.3k |
| 20 | Highmark facility · fee schedule · outpatient · +12 other terms | 33 | $3.9k | $3.6k | $3.6k | 101% | — | $67 – $11.1k |
| 21 | Cigna Healthspring fee schedule · outpatient · +6 other terms | 32 | $148 | $1.3k | $1.5k | 116% | — | $128 – $3.4k |
| 22 | Clover fee schedule · outpatient · +7 other terms | 31 | $3.5k | $3.5k | $202 | 6% | — | $3.0k – $3.8k |
| 23 | First Health fee schedule · outpatient · +20 other terms | 31 | $3.5k | $2.6k | $2.7k | 102% | — | $122 – $7.2k |
| 24 | Tricare fee schedule · outpatient · +16 other terms | 30 | $3.0k | $2.7k | $1.4k | 53% | — | $147 – $5.4k |
| 25 | Medica case rate · outpatient · +17 other terms | 28 | $2.8k | $2.5k | $681 | 27% | — | $977 – $3.2k |
← Hospitals reporting CPT 42330 · Snapshot 20261112T124536Z-e251e855