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
HC Dental Sealant per Tooth
Low
$11
Average
$2.0k
Median
$212
High
$22.7k
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
44 payers; the 90th percentile is 188.4× 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 | Superior Healthplan facility · other · outpatient · +1 other terms | 2 | $6.6k | $6.6k | $3.0k | 45% | 1–10 | $3.6k – $9.8k |
| 2 | Humana fee schedule · outpatient · +11 other terms | 75 | $74 | $115 | $76 | 66% | — | $1 – $350 |
| 3 | Aetna fee schedule · outpatient · +12 other terms | 33 | $69 | $184 | $307 | 167% | — | $13 – $931 |
| 4 | UnitedHealthcare fee schedule · outpatient · +14 other terms | 31 | $152 | $372 | $508 | 136% | — | $20 – $1.2k |
| 5 | Molina facility · case rate · outpatient · +9 other terms | 30 | $437 | $515 | $523 | 102% | — | $28 – $1.6k |
| 6 | Blue Cross Blue Shield facility · fee schedule · outpatient · +15 other terms | 26 | $70 | $531 | $1.8k | 343% | — | $23 – $22k |
| 7 | Anthem professional · fee schedule · outpatient · +6 other terms | 17 | $29 | $46 | $25 | 54% | — | $23 – $104 |
| 8 | Caresource facility · case rate · outpatient · +5 other terms | 15 | $970 | $1.0k | $239 | 23% | — | $648 – $1.6k |
| 9 | Baylor Scott White Health Plan facility · percent of total billed charges · outpatientfrom % of charges | 14 | $11 | $11 | $1 | 8% | — | $10 – $12 |
| 10 | Optum facility · case rate · outpatient · +4 other terms | 13 | $862 | $839 | $400 | 48% | — | $31 – $1.5k |
| 11 | Cigna professional · fee schedule · outpatient · +11 other terms | 10 | $17 | $17 | $1 | 3% | — | $17 – $18 |
| 12 | Clover facility · percent of total billed charges · outpatientfrom % of charges | 10 | $19 | $19 | — | — | — | $19 – $19 |
| 13 | Highmark fee schedule · outpatient · +6 other terms | 10 | $120 | $112 | $274 | 244% | — | $34 – $1.1k |
| 14 | Medcost percent of total billed charges · bothfrom % of charges | 9 | $40 | $40 | $2 | 6% | — | $38 – $42 |
| 15 | Aetna Better Health facility · case rate · outpatient · +4 other terms | 7 | $39 | $39 | $0 | 1% | — | $37 – $39 |
| 16 | Amerihealth Caritas facility · case rate · outpatient · +3 other terms | 7 | $36 | $36 | $1 | 3% | — | $36 – $39 |
| 17 | Medicaid fee schedule · outpatient · +4 other terms | 7 | $108 | $108 | — | — | — | $108 – $108 |
| 18 | Excellus facility · fee schedule · outpatient · +6 other terms | 5 | $660 | $6.5k | $9.8k | 152% | — | $8 – $22k |
| 19 | Medica fee schedule · outpatient · +3 other terms | 5 | $30 | $26 | $5 | 20% | — | $20 – $30 |
| 20 | Phcs facility · percent of total billed charges · outpatientfrom % of charges · +2 other terms | 5 | $18.9k | $24.9k | $31.2k | 125% | — | $31 – $84.8k |
| 21 | Tricare facility · fee schedule · outpatient · +3 other terms | 5 | $50k | $35.7k | $22.6k | 63% | — | $36 – $50k |
| 22 | Kaiser fee schedule · outpatient · +3 other terms | 4 | $253 | $245 | $143 | 58% | — | $108 – $523 |
| 23 | Oscar professional · percent of total billed charges · outpatientfrom % of charges | 4 | $19 | $19 | — | — | — | $19 – $19 |
| 24 | Regence facility · fee schedule · outpatient · +1 other terms | 4 | $349 | $416 | $309 | 74% | — | $23 – $660 |
| 25 | Ambetter facility · other · outpatient · +3 other terms | 3 | $1.1k | $1.1k | $53 | 5% | — | $1.0k – $1.2k |
← Hospitals reporting HCPCS D1351 · Snapshot 20261111T120946Z-9134e7f7