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
DENTAL BITEWING SINGLE IMAGE
The hospitals that file a Tricare 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.
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28 hospital rates
| # | Plans | |||
|---|---|---|---|---|
| 1 | Beaufort Memorial Hospital Beaufort, SC facility · fee schedule · outpatient | 1 | $86.76 | $86.76 – $86.76 |
| 2 | Bon Secours Community Hospital Jervis, NY facility · fee schedule · outpatient | 1 | $6,089 | $6,089 – $6,089 |
| 3 | Boston Medical Center Boston, MA other · both | 1 | $99.34 | $99.34 – $99.34 |
| 4 | Butler Healthcare Providers_ DBA Butler Memorial Hospital Butler, PA facility · case rate · outpatient | 1 | $84.71 | $84.71 – $84.71 |
| 5 | CLAIBORNE MEDICAL CENTER Tazewell, TN fee schedule · outpatient | 1 | $84.56 | $84.56 – $84.56 |
| 6 | CUMBERLAND MEDICAL CENTER, INC. Crossville, TN fee schedule · outpatient | 1 | $84.56 | $84.56 – $84.56 |
| 7 | Charleston Area Medical Center Charleston, WV percent of total billed charges · bothfrom % of charges | 1 | $16.20 | $16.20 – $16.20 |
| 8 | Clarion Hospital Clarion, PA facility · case rate · outpatient | 1 | $84.71 | $84.71 – $84.71 |
| 9 | FORT LOUDOUN MEDICAL CENTER Lenoir City, TN fee schedule · outpatient | 1 | $78.96 | $78.96 – $78.96 |
| 10 | FORT SANDERS REGIONAL MEDICAL CENTER Knoxville, TN fee schedule · outpatient | 1 | $78.96 | $78.96 – $78.96 |
| 11 | Gerald Champion Regional Medical Center Alamogordo, NM fee schedule · outpatient | 5 | $86.58 | $86.58 – $86.58 |
| 12 | Good Samaritan Hospital Suffern, NY facility · fee schedule · outpatient | 1 | $6,089 | $6,089 – $6,089 |
| 13 | IHC Health Services Inc., DBA Intermountain Primary Children's Hospital City, UT facility · fee schedule · outpatient | 1 | $84.41 | $84.41 – $84.41 |
| 14 | IHC Health Services Inc., DBA Intermountain Primary Children's Hospital Lehi, UT facility · fee schedule · outpatient | 1 | $84.41 | $84.41 – $84.41 |
| 15 | LECONTE MEDICAL CENTER Sevierville, TN fee schedule · outpatient | 1 | $84.56 | $84.56 – $84.56 |
| 16 | METHODIST MEDICAL CENTER OF OAK RIDGE Oak Ridge, TN fee schedule · outpatient | 1 | $78.96 | $78.96 – $78.96 |
| 17 | MORRISTOWN HAMBLEN HOSPITAL ASSOCIATION Morristown, TN fee schedule · outpatient | 1 | $78.96 | $78.96 – $78.96 |
| 18 | MVHS, Inc. Utica, NY other · outpatient | 1 | $98.99 | $98.99 – $98.99 |
| 19 | Mid Hudson Regional Hospital Poughkeepsie, NY facility · fee schedule · outpatient | 1 | $3,099 | $108.63 – $6,089 |
| 20 | NATIONWIDE CHILDREN'S HOSPITAL TOLEDO, LLC Toledo, OH facility · fee schedule · outpatient | 1 | $83.65 | $83.65 – $83.65 |
| 21 | Nationwide Children's Hospital Columbus, OH facility · fee schedule · outpatient | 1 | $83.65 | $83.65 – $83.65 |
| 22 | Nationwide Children's Hospital Columbus, OH professional · percent of total billed charges · outpatientfrom % of charges | 1 | $17.50 | $17.50 – $17.50 |
| 23 | PARKWEST MEDICAL CENTER Knoxville, TN fee schedule · outpatient | 1 | $78.96 | $78.96 – $78.96 |
| 24 | PARKWEST MEDICAL CENTER Louisville, TN fee schedule · outpatient | 1 | $78.96 | $78.96 – $78.96 |
| 25 | Public Hospital District NO 2 Skagit County Washington Anacortes, WA facility · fee schedule · outpatient | 1 | $103.86 | $103.86 – $103.86 |
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