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 PROPHYLAXIS CHILD
Low
$1
Average
$3.7k
Median
$89
High
$35k
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Reflects a payer-specific billing methodology not covered by the standard categories.
Showing only prices reported under the other methodology. Choose another in the filter above to change the chart. 15 hospitals; the 90th percentile is 6775.0× 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.
Click a bar to filter the hospitals table to that price range.
| # | Hospital | ||||||
|---|---|---|---|---|---|---|---|
| 1 | Wesley Health System LLC Hattiesburg, MS | $3.4k | $6.7k | $8.6k | 129% | 19–28 | $35 – $24.2k |
| 2 | Vicksburg Healthcare LLC Vicksburg, MS | $1.9k | $8.0k | $13.1k | 165% | — | $35 – $36.8k |
| 3 | Kirksville Missouri Hospital Co LLC Kirksville, MO | $3k | $2.8k | $236 | 8% | — | $34 – $27.2k |
| 4 | Covenant Medical Center Inc Waterloo, IA | $625 | $678 | $130 | 19% | — | $0 – $1.0k |
| 5 | The Cleveland Clinic Foundation Cleveland, OH | $1 | $1 | — | — | — | $1 – $114 |
| 6 | The Union Hospital Association Dover, OH | $1 | $1 | — | — | — | $1 – $65 |
| 7 | Akron General Medical Center Akron, OH | $1 | $1 | — | — | — | $1 – $114 |
| 8 | Cleveland Clinic Mercy Hospital Canton, OH | $1 | $1 | — | — | — | $1 – $67 |
| 9 | University of Florida Health Gainesville, FL | $89 | $89 | — | — | — | $89 – $89 |
| 10 | UF Health The Villages, FL | $85 | $85 | — | — | — | $85 – $85 |
Ask Claude or any MCP client for HCPCS D1120 pricing at a specific hospital — see how to connect.