Partial maxillary denture adjustment

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.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

Dentures adjust part maxill

Payers reporting HCPCS D5421

Payer pricing summary

Low

$10

Average

$131

Median

$66

High

$1.6k

Payer rate distribution

Filter by billing methodology

Filter by billing class

#
1	Humana fee schedule · outpatient · +8 other terms	71	$215	$177	$102	57%	—	$34 – $339
2	Molina facility · case rate · outpatient · +7 other terms	29	$89	$134	$81	60%	—	$37 – $338
3	Aetna fee schedule · outpatient · +10 other terms	28	$54	$117	$135	115%	—	$21 – $619
4	UnitedHealthcare fee schedule · outpatient · +13 other terms	24	$49	$67	$67	101%	—	$11 – $323
5	Anthem professional · fee schedule · outpatient · +6 other terms	17	$38	$66	$38	57%	—	$36 – $150
6	Caresource facility · case rate · outpatient · +2 other terms	15	$53	$57	$13	23%	—	$36 – $90
7	Optum facility · case rate · outpatient · +3 other terms	14	$51	$72	$41	57%	—	$44 – $167
8	MultiPlan facility · percent of total billed charges · outpatientfrom % of charges · +6 other terms	13	$48	$51	$12	23%	—	$48 – $91
9	Blue Cross Blue Shield facility · fee schedule · outpatient · +10 other terms	11	$123	$152	$79	52%	—	$123 – $389
10	Highmark fee schedule · outpatient · +2 other terms	11	$42	$45	$20	45%	—	$42 – $242
11	Cigna professional · fee schedule · outpatient · +6 other terms	10	$28	$28	$1	2%	—	$28 – $29
12	Clover facility · percent of total billed charges · outpatientfrom % of charges	10	$10	$10	—	—	—	$10 – $10
13	Aetna Better Health facility · case rate · outpatient · +1 other terms	7	$211	$208	$9	4%	—	$175 – $211
14	Amerihealth Caritas facility · case rate · outpatient · +3 other terms	7	$193	$196	$6	3%	—	$193 – $211
15	Medicaid fee schedule · outpatient · +1 other terms	7	$118	$118	—	—	—	$118 – $118
16	Medica fee schedule · outpatient · +3 other terms	5	$51	$37	$11	29%	—	$24 – $51
17	Kaiser fee schedule · outpatient · +1 other terms	4	$257	$249	$140	56%	—	$118 – $523
18	Oscar professional · percent of total billed charges · outpatientfrom % of charges	4	$34	$34	—	—	—	$34 – $34
19	Wellmark facility · case rate · outpatient	3	$573	$503	$159	32%	—	$234 – $633
20	Excellus fee schedule · outpatient · +4 other terms	2	$62	$63	$54	85%	—	$16 – $135
21	Bcbs Id professional · fee schedule · outpatient	1	$62	$62	—	—	—	$62 – $62
22	Bcbs Mn fee schedule · outpatient	1	$129	$129	—	—	—	$129 – $129
23	Bcbs Nv fee schedule · outpatient	1	$35	$35	—	—	—	$35 – $35
24	Bcbs Ny percent of total billed charges · bothfrom % of charges	1	$25	$25	—	—	—	$25 – $25
25	Bcbs Tx percent of total billed charges · outpatientfrom % of charges	1	$36	$36	$4	11%	—	$32 – $40

Page 1 of 2 · 35 payers