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
Bone graft peri per tooth
Low
$164
Average
$2.6k
Median
$1.7k
High
$35k
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
46 payers; the 90th percentile is 5.9× 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 | Aetna fee schedule · outpatient · +5 other terms | 191 | $1.6k | $2.5k | $3.8k | 150% | — | $79 – $33.6k |
| 2 | UnitedHealthcare fee schedule · outpatient · +6 other terms | 141 | $1.6k | $1.6k | $3.1k | 193% | — | $131 – $48.9k |
| 3 | Humana fee schedule · outpatient · +4 other terms | 137 | $904 | $1.1k | $571 | 50% | — | $167 – $3.7k |
| 4 | Blue Cross Blue Shield fee schedule · outpatient · +3 other terms | 102 | $695 | $1.7k | $2.2k | 124% | — | $155 – $13.2k |
| 5 | Cigna fee schedule · outpatient · +4 other terms | 90 | $898 | $2.2k | $3.0k | 135% | — | $602 – $20.7k |
| 6 | WellCare fee schedule · outpatient · +2 other terms | 69 | $1.6k | $1.7k | $1.0k | 61% | — | $595 – $3.9k |
| 7 | Molina fee schedule · outpatient · +5 other terms | 59 | $1.6k | $1.3k | $480 | 37% | — | $260 – $2.7k |
| 8 | Ambetter facility · fee schedule · outpatient · +1 other terms | 42 | $1.5k | $2.6k | $1.4k | 53% | — | $777 – $4.3k |
| 9 | Anthem facility · fee schedule · outpatient · +6 other terms | 41 | $1.6k | $2.7k | $2.2k | 80% | — | $114 – $7.7k |
| 10 | Devoted fee schedule · outpatient · +1 other terms | 38 | $1.2k | $1.1k | $548 | 52% | — | $601 – $1.8k |
| 11 | Oscar facility · fee schedule · outpatient · +2 other terms | 27 | $1.9k | $2.2k | $1.6k | 70% | — | $911 – $4.7k |
| 12 | Bcbs Tx fee schedule · outpatient | 23 | $1.6k | $1.6k | $46 | 3% | — | $1.6k – $1.7k |
| 13 | Kaiser fee schedule · outpatient · +1 other terms | 23 | $1.4k | $1.3k | $600 | 46% | — | $719 – $2.8k |
| 14 | Clover fee schedule · outpatient · +1 other terms | 21 | $1.8k | $1.4k | $581 | 40% | — | $584 – $2.0k |
| 15 | Optum fee schedule · outpatient · +3 other terms | 21 | $628 | $1.0k | $541 | 53% | — | $587 – $2.4k |
| 16 | Regence facility · fee schedule · outpatient · +1 other terms | 19 | $680 | $930 | $594 | 64% | — | $220 – $2.7k |
| 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 · +2 other terms | 14 | $1.4k | $1.4k | — | — | — | $1.4k – $1.4k |
| 19 | Highmark fee schedule · outpatient · +2 other terms | 13 | $1.4k | $1.5k | $1.1k | 77% | — | $233 – $4.1k |
| 20 | Tricare facility · fee schedule · outpatient · +1 other terms | 13 | $1.6k | $3.3k | $2.3k | 69% | — | $772 – $6.2k |
| 21 | Bcbs Nj fee schedule · outpatient | 12 | $1.9k | $3.9k | $2.6k | 67% | — | $1.8k – $8.0k |
| 22 | Medica facility · fee schedule · outpatient · +2 other terms | 11 | $1.6k | $1.2k | $716 | 59% | — | $49 – $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 D3428 · Snapshot 20261112T124536Z-e251e855