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
Prev resin rest, perm tooth
Low
$17
Average
$4.5k
Median
$161
High
$50k
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
32 payers; the 90th percentile is 312.6× 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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Filter by billing class
| # | ||||||||
|---|---|---|---|---|---|---|---|---|
| 1 | Humana fee schedule · outpatient · +4 other terms | 70 | $183 | $145 | $85 | 58% | — | $27 – $250 |
| 2 | Molina facility · case rate · outpatient · +5 other terms | 28 | $751 | $560 | $474 | 85% | — | $86 – $1.6k |
| 3 | UnitedHealthcare professional · fee schedule · outpatient · +7 other terms | 22 | $43 | $51 | $19 | 37% | — | $21 – $101 |
| 4 | Aetna fee schedule · outpatient · +9 other terms | 19 | $26 | $75 | $70 | 93% | — | $18 – $206 |
| 5 | Anthem facility · case rate · outpatient · +5 other terms | 15 | $916 | $1.0k | $235 | 23% | — | $623 – $1.6k |
| 6 | Caresource facility · case rate · outpatient | 15 | $934 | $1.0k | $230 | 23% | — | $623 – $1.6k |
| 7 | Optum facility · case rate · outpatient · +3 other terms | 13 | $829 | $815 | $369 | 45% | — | $82 – $1.4k |
| 8 | Blue Cross Blue Shield facility · fee schedule · outpatient · +7 other terms | 12 | $188 | $2.0k | $7.8k | 400% | — | $188 – $37k |
| 9 | MultiPlan facility · percent of total billed charges · outpatientfrom % of charges · +2 other terms | 12 | $384 | $384 | — | — | — | $384 – $384 |
| 10 | Highmark fee schedule · outpatient · +1 other terms | 11 | $34 | $36 | $14 | 38% | — | $34 – $170 |
| 11 | Cigna professional · fee schedule · outpatient · +6 other terms | 10 | $20 | $20 | $1 | 4% | — | $20 – $21 |
| 12 | Clover facility · percent of total billed charges · outpatientfrom % of charges | 10 | $81 | $81 | — | — | — | $81 – $81 |
| 13 | Aetna Better Health facility · case rate · outpatient | 7 | $103 | $103 | $1 | 1% | — | $99 – $103 |
| 14 | Amerihealth Caritas facility · case rate · outpatient · +1 other terms | 7 | $95 | $96 | $3 | 3% | — | $95 – $103 |
| 15 | Tricare facility · fee schedule · outpatient | 5 | $50k | $50k | — | — | — | $50k – $50k |
| 16 | Medica fee schedule · outpatient · +2 other terms | 3 | $35 | $35 | — | — | — | $35 – $35 |
| 17 | Oscar professional · percent of total billed charges · outpatientfrom % of charges | 3 | $41 | $41 | — | — | — | $41 – $41 |
| 18 | Wellmark facility · case rate · outpatient | 3 | $328 | $288 | $91 | 32% | — | $134 – $362 |
| 19 | Medicaid facility · case rate · outpatient | 2 | $86 | $86 | — | — | — | $86 – $86 |
| 20 | Bcbs Id professional · fee schedule · outpatient | 1 | $57 | $57 | — | — | — | $57 – $57 |
| 21 | Bcbs Mn fee schedule · outpatient | 1 | $199 | $199 | — | — | — | $199 – $199 |
| 22 | Bcbs Nv fee schedule · outpatient | 1 | $25 | $25 | — | — | — | $25 – $25 |
| 23 | Bcbs Tx percent of total billed charges · outpatientfrom % of charges | 1 | $39 | $39 | $5 | 12% | — | $34 – $43 |
| 24 | Bcbs Vt professional · fee schedule · outpatient | 1 | $36 | $36 | — | — | — | $36 – $36 |
| 25 | Devoted professional · percent of total billed charges · inpatientfrom % of charges · +1 other terms | 1 | $73 | $73 | — | — | — | $73 – $73 |
← Hospitals reporting HCPCS D1352 · Snapshot 20261112T124536Z-e251e855