HCPCS D1205
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
Topical fluoride w/ prophy a
Prices here combine facility and professional fees. See them separately →Experimental
Low
$32
Average
$49
Median
$32
High
$187
Showing only prices reported under the fee schedule methodology. Choose another in the filter below to change the chart. 9 hospitals; the 90th percentile is 2.0× 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.
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Reflects negotiated fee schedule rates with commercial payers.
| # | Hospital | ||||||
|---|---|---|---|---|---|---|---|
| 1 | Nationwide Children's Hospital Columbus, OH | $187 | $187 | — | — | — | $187 – $187 |
| 2 | St. David's Round Rock Medical Center PFLUGERVILLE, TX | $32 | $32 | — | — | — | $32 – $32 |
| 3 | St. David's South Austin Medical Center BASTROP, TX | $32 | $32 | — | — | — | $32 – $32 |
| 4 | Heart Hosp Of Austin Austin, TX | $32 | $32 | — | — | — | $32 – $32 |
| 5 | Heart Hosp Of Austin At St. David's Round Rock ROUND ROCK, TX | $32 | $32 | — | — | — | $32 – $32 |
| 6 | St. David's Medical Center Austin, TX | $32 | $32 | — | — | — | $32 – $32 |
| 7 | St. David's North Austin Medical Center Austin, TX | $32 | $32 | — | — | — | $32 – $32 |
| 8 | St. David's Georgetown Hospital Georgetown, TX | $32 | $32 | — | — | — | $32 – $32 |
| 9 | St Davids Rehab Austin, TX | $32 | $32 | — | — | — | $32 – $32 |
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