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
Inlay composite/resin two su
Low
$558
Average
$2.2k
Median
$1.6k
High
$22.3k
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
48 payers; the 90th percentile is 3.7× 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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| # | ||||||||
|---|---|---|---|---|---|---|---|---|
| 1 | Humana fee schedule · outpatient · +7 other terms | 163 | $1.4k | $1.4k | $787 | 56% | — | $307 – $4.2k |
| 2 | Aetna fee schedule · outpatient · +8 other terms | 157 | $999 | $1.5k | $1.1k | 74% | — | $187 – $5.6k |
| 3 | UnitedHealthcare fee schedule · outpatient · +9 other terms | 127 | $1.6k | $1.7k | $3.1k | 182% | — | $291 – $48.9k |
| 4 | Blue Cross Blue Shield facility · fee schedule · outpatient · +5 other terms | 83 | $1.7k | $1.5k | $699 | 48% | — | $298 – $4.2k |
| 5 | WellCare fee schedule · outpatient · +2 other terms | 68 | $1.6k | $1.7k | $1.0k | 60% | — | $595 – $3.9k |
| 6 | Cigna fee schedule · outpatient · +7 other terms | 65 | $864 | $1.3k | $1.2k | 88% | — | $616 – $5.3k |
| 7 | Molina fee schedule · outpatient · +5 other terms | 50 | $1.6k | $1.4k | $477 | 35% | — | $228 – $2.7k |
| 8 | Anthem facility · fee schedule · outpatient · +5 other terms | 42 | $2.3k | $2.9k | $2.2k | 75% | — | $612 – $7.7k |
| 9 | Ambetter facility · fee schedule · outpatient · +1 other terms | 35 | $2.8k | $2.9k | $1.3k | 47% | — | $822 – $4.3k |
| 10 | Devoted fee schedule · outpatient · +1 other terms | 34 | $1.7k | $1.1k | $561 | 51% | — | $601 – $1.8k |
| 11 | Bcbs Tx fee schedule · outpatient · +1 other terms | 23 | $1.6k | $1.6k | $46 | 3% | — | $1.6k – $1.7k |
| 12 | Optum facility · fee schedule · outpatient · +3 other terms | 22 | $1.5k | $1.5k | $297 | 20% | — | $615 – $2.0k |
| 13 | Clover fee schedule · outpatient · +2 other terms | 21 | $1.8k | $1.4k | $581 | 40% | — | $584 – $2.0k |
| 14 | Oscar facility · fee schedule · outpatient · +2 other terms | 19 | $963 | $1.3k | $578 | 44% | — | $911 – $2.7k |
| 15 | Regence facility · fee schedule · outpatient · +1 other terms | 19 | $680 | $945 | $579 | 61% | — | $535 – $2.7k |
| 16 | Kaiser fee schedule · outpatient · +1 other terms | 17 | $1.4k | $1.3k | $634 | 49% | — | $719 – $2.8k |
| 17 | Caresource facility · case rate · outpatient · +3 other terms | 15 | $1.5k | $8.6k | $26.7k | 309% | — | $1.4k – $108.4k |
| 18 | MultiPlan fee schedule · outpatient · +4 other terms | 14 | $1.4k | $1.4k | — | — | — | $1.4k – $1.4k |
| 19 | Highmark fee schedule · outpatient · +2 other terms | 13 | $1.5k | $1.5k | $1.0k | 67% | — | $228 – $4.1k |
| 20 | Bcbs Nj fee schedule · outpatient | 12 | $1.9k | $3.9k | $2.6k | 67% | — | $1.8k – $8.0k |
| 21 | Tricare fee schedule · outpatient · +1 other terms | 12 | $587 | $684 | $113 | 16% | — | $587 – $839 |
| 22 | Medica facility · fee schedule · outpatient · +2 other terms | 10 | $1.6k | $1.2k | $683 | 55% | — | $100 – $1.8k |
| 23 | Ucare facility · fee schedule · outpatient | 10 | $1.6k | $1.3k | $437 | 33% | — | $705 – $1.8k |
| 24 | Medical Mutual fee schedule · outpatient · +1 other terms | 9 | $4.6k | $4.7k | $522 | 11% | — | $3.9k – $5.3k |
| 25 | Healthpartners facility · fee schedule · outpatient · +1 other terms | 8 | $1.7k | $2.1k | $987 | 48% | — | $1.6k – $4.7k |
← Hospitals reporting HCPCS D2651 · Snapshot 20261112T124536Z-e251e855