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
Surg exp root surf molar
Low
$164
Average
$2.5k
Median
$1.6k
High
$37.5k
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
50 payers; the 90th percentile is 5.7× 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 | UnitedHealthcare case rate · outpatient · +6 other terms | 270 | $6.3k | $5.2k | $4.0k | 77% | — | $1 – $30k |
| 2 | Aetna fee schedule · outpatient · +5 other terms | 247 | $831 | $1.3k | $966 | 75% | — | $254 – $5.6k |
| 3 | Humana fee schedule · outpatient · +5 other terms | 152 | $1.5k | $1.4k | $768 | 56% | — | $367 – $4.4k |
| 4 | Blue Cross Blue Shield fee schedule · outpatient · +6 other terms | 132 | $831 | $1.3k | $988 | 74% | — | $361 – $6.5k |
| 5 | Cigna fee schedule · outpatient · +5 other terms | 87 | $714 | $1.2k | $1.1k | 87% | — | $616 – $5.3k |
| 6 | WellCare fee schedule · outpatient · +2 other terms | 86 | $1.6k | $1.8k | $1.1k | 62% | — | $595 – $4.3k |
| 7 | Molina fee schedule · outpatient · +5 other terms | 77 | $1.3k | $1.2k | $448 | 36% | — | $260 – $2.7k |
| 8 | Ambetter facility · fee schedule · outpatient · +2 other terms | 43 | $1.5k | $2.6k | $1.4k | 54% | — | $822 – $4.3k |
| 9 | Devoted fee schedule · outpatient · +1 other terms | 43 | $709 | $1.0k | $533 | 52% | — | $601 – $1.8k |
| 10 | Anthem facility · fee schedule · outpatient · +5 other terms | 42 | $1.6k | $2.7k | $2.2k | 80% | — | $114 – $7.7k |
| 11 | Optum fee schedule · outpatient · +3 other terms | 41 | $1.3k | $1.2k | $474 | 39% | — | $587 – $2.4k |
| 12 | Clover fee schedule · outpatient · +1 other terms | 26 | $1.9k | $1.9k | $1.1k | 60% | — | $584 – $4.4k |
| 13 | Kaiser fee schedule · outpatient · +1 other terms | 26 | $1.4k | $1.6k | $1.0k | 64% | — | $719 – $4.3k |
| 14 | Oscar facility · fee schedule · outpatient · +2 other terms | 25 | $1.1k | $1.3k | $520 | 41% | — | $911 – $2.7k |
| 15 | Bcbs Tx fee schedule · outpatient | 23 | $1.6k | $1.6k | $46 | 3% | — | $1.6k – $1.7k |
| 16 | Bcbs La fee schedule · outpatient | 21 | $1.5k | $1.6k | $95 | 6% | — | $1.5k – $2.0k |
| 17 | Regence facility · fee schedule · outpatient · +1 other terms | 19 | $681 | $953 | $575 | 60% | — | $655 – $2.7k |
| 18 | Caresource fee schedule · outpatient · +5 other terms | 17 | $984 | $1.6k | $1.4k | 85% | — | $630 – $4.3k |
| 19 | Tricare fee schedule · outpatient · +2 other terms | 17 | $628 | $1.7k | $1.9k | 109% | — | $587 – $5.1k |
| 20 | MultiPlan fee schedule · outpatient · +2 other terms | 14 | $1.4k | $1.4k | — | — | — | $1.4k – $1.4k |
| 21 | Highmark fee schedule · outpatient · +1 other terms | 13 | $2.0k | $2.1k | $820 | 39% | — | $260 – $4.1k |
| 22 | Bcbs Nj fee schedule · outpatient | 12 | $1.9k | $3.9k | $2.6k | 67% | — | $1.8k – $8.0k |
| 23 | Medical Mutual fee schedule · outpatient · +1 other terms | 10 | $4.6k | $2.7k | $1.8k | 64% | — | $561 – $5.3k |
| 24 | Ucare facility · fee schedule · outpatient | 10 | $1.6k | $1.3k | $437 | 33% | — | $705 – $1.8k |
| 25 | Medica facility · fee schedule · outpatient · +3 other terms | 9 | $1.7k | $1.2k | $689 | 57% | — | $73 – $2.0k |
← Hospitals reporting HCPCS D3503 · Snapshot 20261112T124536Z-e251e855