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
Dental onlay porcelin 3 surf
Low
$79
Average
$1.3k
Median
$852
High
$4.3k
Each hospital's average Aetna rate, under the methodology and billing class chosen below.
312 hospitals; the 90th percentile is 3.2× 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.
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334 hospital rates
iThe hospitals that file a Aetna 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 | AKRON GENERAL MEDICAL CENTER Akron, OH facility · fee schedule · outpatient | 1 | $612 | $612 | — | — | — | $612 – $612 |
| 2 | AKRON GENERAL MEDICAL CENTER Akron, OH professional · percent of total billed charges · outpatientfrom % of charges | 3 | $1.6k | $1.7k | $216 | 13% | — | $1.5k – $2k |
| 3 | ALBANY MEDICAL CENTER HOSPITAL Albany, NY facility · fee schedule · outpatient | 2 | $3.1k | $3.1k | $1.0k | 33% | — | $2.1k – $4.1k |
| 4 | ALLE-KISKI MEDICAL CENTER NATRONA HEIGHTS, PA fee schedule · outpatient | 2 | $2.9k | $2.9k | $1.2k | 42% | — | $1.7k – $4.0k |
| 5 | Acadia Hospital Bangor, ME facility · fee schedule · outpatient | 1 | $1.6k | $1.6k | — | — | — | $1.6k – $1.6k |
| 6 | Acadia Hospital Bangor, ME professional · fee schedule · outpatient | 1 | $650 | $650 | — | — | — | $650 – $650 |
| 7 | AdventHealth Orlando Winter Park, FL fee schedule · outpatient | 1 | $722 | $722 | — | — | — | $722 – $722 |
| 8 | Alomere Health Alexandria, MN facility · fee schedule · outpatient | 1 | $667 | $667 | — | — | — | $667 – $667 |
| 9 | Altru Hospital Devils Lake Devils Lake, ND facility · fee schedule · outpatient | 2 | $694 | $848 | $242 | 29% | — | $660 – $1.2k |
| 10 | Aspirus Divine Savior Hospital Portage, WI fee schedule · outpatient | 1 | $628 | $628 | — | — | — | $628 – $628 |
| 11 | Aspirus Rhinelander Hospital Rhinelander, WI fee schedule · outpatient | 1 | $628 | $628 | — | — | — | $628 – $628 |
| 12 | Aspirus St. Luke’s Hospital Duluth, MN fee schedule · outpatient | 1 | $689 | $689 | — | — | — | $689 – $689 |
| 13 | Aspirus Stevens Point Hospital Stevens Point, WI fee schedule · outpatient | 1 | $628 | $628 | — | — | — | $628 – $628 |
| 14 | Aspirus Wausau Hospital Wausau, WI fee schedule · outpatient | 1 | $631 | $631 | — | — | — | $631 – $631 |
| 15 | Aspirus Wisconsin Rapids Hospital Wisconsin Rapids, WI fee schedule · outpatient | 1 | $628 | $628 | — | — | — | $628 – $628 |
| 16 | BELLEVUE MEDICAL CENTER LLC Bellevue, NE fee schedule · outpatient | 1 | $79 | $79 | — | — | — | $79 – $79 |
| 17 | Baptist Medical Center of Nassau, INC Yulee, FL facility · fee schedule · outpatient | 1 | $1.7k | $1.7k | — | — | — | $1.7k – $1.7k |
| 18 | Baptist Medical Center of the Beaches, INC Beach, FL facility · fee schedule · outpatient | 1 | $1.7k | $1.7k | — | — | — | $1.7k – $1.7k |
| 19 | Bartow Regional Medical Center Bartow, FL facility · fee schedule · outpatient | 2 | $1.8k | $1.8k | $125 | 7% | — | $1.7k – $1.9k |
| 20 | Baycare Hospital Wesley Chapel Chapel, FL facility · fee schedule · outpatient | 2 | $1.8k | $1.8k | $125 | 7% | — | $1.7k – $1.9k |
| 21 | Beaufort Memorial Hospital Beaufort, SC facility · fee schedule · outpatient | 1 | $1.6k | $1.6k | — | — | — | $1.6k – $1.6k |
| 22 | Berger Hospital Circleville, OH fee schedule · outpatient | 2 | $825 | $825 | $202 | 24% | — | $623 – $1.0k |
| 23 | Bethesda Hospital Inc. Lebanon, OH facility · fee schedule · outpatient | 2 | $957 | $854 | $159 | 19% | — | $630 – $976 |
| 24 | Blue Hill Memorial Hospital Hill, ME professional · fee schedule · outpatient | 1 | $650 | $650 | — | — | — | $650 – $650 |
| 25 | Brunswick Community Hospital, LLC Bolivia, NC fee schedule · outpatient | 1 | $711 | $711 | — | — | — | $711 – $711 |
← Payers reporting HCPCS D2643 · Snapshot 20261112T124536Z-e251e855