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
Osseous surg 1 to 3 teeth
Low
$767
Average
$1.8k
Median
$767
High
$3.8k
Each hospital's average Amerihealth Caritas rate, under the methodology and billing class chosen below.
15 hospitals; the 90th percentile is 4.5× 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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15 hospital rates
iThe hospitals that file a Amerihealth Caritas 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 | Baptist Medical Center of Nassau, INC Yulee, FL facility · case rate · outpatient | 1 | $767 | $767 | — | — | — | $767 – $767 |
| 2 | Baptist Medical Center of the Beaches, INC Beach, FL facility · case rate · outpatient | 1 | $767 | $767 | — | — | — | $767 – $767 |
| 3 | Bayhealth Hospital, Sussex Campus Milton, DE fee schedule · outpatient | 1 | $3.7k | $3.7k | — | — | — | $3.7k – $3.7k |
| 4 | Bayhealth Medical Center, Kent Campus Dover, DE fee schedule · outpatient | 1 | $3.8k | $3.8k | — | — | — | $3.8k – $3.8k |
| 5 | Henry Ford Health System West Bloomfield, MI facility · fee schedule · outpatient | 1 | $3.2k | $3.2k | — | — | — | $3.2k – $3.2k |
| 6 | Henry Ford Health System Plymouth, MI facility · fee schedule · outpatient | 1 | $3.2k | $3.2k | — | — | — | $3.2k – $3.2k |
| 7 | Henry Ford Macomb Hospital Corporation Clinton Twp, MI facility · fee schedule · outpatient | 1 | $3.2k | $3.2k | — | — | — | $3.2k – $3.2k |
| 8 | Henry Ford Wyandotte Hospital Brownstown Charter Twp., MI facility · fee schedule · outpatient | 1 | $3.2k | $3.2k | — | — | — | $3.2k – $3.2k |
| 9 | Sarasota Memorial Hospital Sarasota, FL case rate · outpatient | 1 | $767 | $767 | — | — | — | $767 – $767 |
| 10 | Sarasota Memorial Hospital - Venice North Venice, FL case rate · outpatient | 1 | $767 | $767 | — | — | — | $767 – $767 |
| 11 | Southern Baptist Hospital of Florida, INC Fleming Island, FL facility · case rate · outpatient | 1 | $767 | $767 | — | — | — | $767 – $767 |
| 12 | Southern Baptist Hospital of Florida, INC FL 32222; 461 Outlet Mall Blvd St. Augustine, FL facility · case rate · outpatient | 1 | $767 | $767 | — | — | — | $767 – $767 |
| 13 | Southern Baptist Hospital of Florida, INC Jacksonville, FL facility · case rate · outpatient | 1 | $767 | $767 | — | — | — | $767 – $767 |
| 14 | Southern Baptist Hospital of Florida, INC Jacksonville, FL facility · case rate · outpatient | 1 | $767 | $767 | — | — | — | $767 – $767 |
| 15 | University of Florida Health Gainesville, FL facility · case rate · outpatient | 1 | $836 | $836 | — | — | — | $836 – $836 |
← Payers reporting HCPCS D4261 · Snapshot 20261112T124536Z-e251e855