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
Low
$11
Average
$2.1k
Median
$41
High
$50k
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Prices here combine facility and professional fees. See them separately →Experimental
Reflects negotiated fee schedule rates with commercial payers.
Showing only prices reported under the fee schedule methodology. Choose another in the filter above to change the chart. 131 hospitals; the 90th percentile is 5.0× 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 | St. Anthony Shawnee Hospital, Inc Shawnee, OK | $30 | $30 | — | — | — | $30 – $30 |
| 2 | Beth Israel Deaconess Hospital - Needham Needham, MA | $41 | $41 | — | — | — | $41 – $41 |
| 3 | Mayo Regional Hospital Dover Foxcroft, ME | $18 | $19 | $4 | 23% | — | $15 – $27 |
| 4 | Baptist Medical Center of the Beaches, INC Beach, FL | $36 | $36 | — | — | — | $36 – $36 |
| 5 | Westfield Memorial Hospital Inc WESTFIELD, NY | $34 | $30 | $7 | 22% | — | $17 – $34 |
| 6 | Gundersen Luthern Medical Center Inc La Crosse, WI | $23 | $30 | $15 | 51% | — | $23 – $62 |
| 7 | CHRISTUS Good Shepherd Hospital - Northpark Longview, TX | $12 | $12 | — | — | — | $12 – $12 |
| 8 | University Medical Center of Southern Nevada Las Vegas, NV | $17 | $17 | $1 | 8% | — | $17 – $25 |
| 9 | Garnet Health Medical Center Middletown, NY | $62 | $62 | — | — | — | $62 – $62 |
| 10 | Nationwide Children's Hospital Columbus, OH | $72 | $72 | $26 | 36% | — | $46 – $97 |
Ask Claude or any MCP client for HCPCS D1353 pricing at a specific hospital — see how to connect.