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
SEALANT REPAIR PER TOOTH
Based on 1–10 billing samples across every hospital reporting.
Low
$11
Average
$1.3k
Median
$49
High
$35k
Filter by billing methodology
Prices here combine facility and professional fees. See them separately →Experimental
Showing prices across every billing methodology. Pick one in the filter above to narrow the chart. 171 hospitals; the 90th percentile is 44.6× 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 | Novant Health New Hanover Regional Medical Center LLC Wilmington, NC | $545 | $545 | — | — | 1–10 | $545 – $545 |
| 2 | St. Anthony Shawnee Hospital, Inc Shawnee, OK | $30 | $30 | — | — | — | $30 – $30 |
| 3 | Beth Israel Deaconess Hospital - Needham Needham, MA | $41 | $41 | — | — | — | $41 – $41 |
| 4 | Mayo Regional Hospital Dover Foxcroft, ME | $18 | $19 | $4 | 23% | — | $15 – $27 |
| 5 | Baptist Medical Center of the Beaches, INC Beach, FL | $36 | $36 | $2 | 6% | — | $32 – $39 |
| 6 | Westfield Memorial Hospital Inc WESTFIELD, NY | $34 | $30 | $7 | 22% | — | $17 – $34 |
| 7 | Gundersen Luthern Medical Center Inc La Crosse, WI | $23 | $29 | $15 | 50% | — | $22 – $62 |
| 8 | Jefferson County Hospital OK Waurika, OK | $148 | $170 | $31 | 18% | — | $141 – $221 |
| 9 | CHRISTUS Good Shepherd Hospital - Northpark Longview, TX | $12 | $12 | — | — | — | $12 – $12 |
| 10 | Fairview Hospital Cleveland, OH | $952 | $950 | $35 | 4% | — | $862 – $998 |
Ask Claude or any MCP client for HCPCS D1353 pricing at a specific hospital — see how to connect.