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
Fixed bilat space maintainer
Low
$60
Average
$206
Median
$123
High
$516
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5 hospital rates
iThe hospitals that file a UnitedHealthcare rate for this code, one row per hospital and set of terms (billing class, payment method, setting). Rates under different terms are never blended, so the terms are shown under each hospital’s name. Figures are the hospital’s averages across its plans.| # | Plans | |||||||
|---|---|---|---|---|---|---|---|---|
| 1 | Gundersen Luthern Medical Center Inc La Crosse, WI facility · fee schedule · outpatient | 1 | $60 | $60 | — | — | — | $60 – $60 |
| 2 | LODI MEMORIAL HOSPITAL ASSOCIATION INC Lodi, CA fee schedule · outpatient | 1 | $152 | $152 | — | — | — | $152 – $152 |
| 3 | SONORA COMMUNITY HOSPITAL Sonora, CA fee schedule · outpatient | 1 | $152 | $152 | — | — | — | $152 – $152 |
| 4 | SONORA COMMUNITY HOSPITAL Sonora, CA percent of total billed charges · outpatientfrom % of charges | 4 | $550 | $607 | $131 | 22% | — | $496 – $831 |
| 5 | University of Florida Health Gainesville, FL facility · case rate · outpatient | 2 | $95 | $95 | — | — | — | $95 – $95 |
← Payers reporting HCPCS D1515 · Snapshot 20261112T181611Z-3fa9fb76