ADD TOOTH TO PARTIAL DENTURE

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.

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Original text from hospital filings

Add tooth to partial denture

Payers reporting HCPCS D5650

Payer pricing summary

Low

$63

Average

$2.4k

Median

$269

High

$27.9k

Payer rate distribution

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#
1	Humana fee schedule · outpatient · +8 other terms	71	$301	$420	$244	58%	—	$84 – $735
2	Molina facility · case rate · outpatient · +7 other terms	30	$902	$4.2k	$19.3k	457%	—	$115 – $111.7k
3	Aetna fee schedule · outpatient · +12 other terms	26	$79	$191	$174	91%	—	$52 – $742
4	UnitedHealthcare professional · fee schedule · outpatient · +12 other terms	24	$139	$169	$57	34%	—	$76 – $310
5	Anthem professional · fee schedule · outpatient · +6 other terms	16	$99	$168	$94	56%	—	$92 – $378
6	Caresource facility · case rate · outpatient · +2 other terms	15	$1.5k	$8.6k	$26.7k	309%	—	$1.4k – $108.4k
7	MultiPlan facility · percent of total billed charges · outpatientfrom % of charges · +5 other terms	15	$403	$360	$87	24%	—	$169 – $403
8	Blue Cross Blue Shield facility · fee schedule · outpatient · +10 other terms	13	$326	$1.3k	$4.4k	353%	—	$76 – $22k
9	Optum facility · case rate · outpatient · +3 other terms	13	$1.4k	$1.2k	$451	39%	—	$109 – $1.4k
10	Highmark fee schedule · outpatient · +3 other terms	11	$100	$105	$39	37%	—	$100 – $480
11	Cigna professional · fee schedule · outpatient · +6 other terms	10	$71	$71	$1	1%	—	$71 – $73
12	Clover facility · percent of total billed charges · outpatientfrom % of charges	10	$85	$85	—	—	—	$85 – $85
13	Aetna Better Health facility · case rate · outpatient · +1 other terms	7	$138	$139	$5	4%	—	$132 – $157
14	Amerihealth Caritas facility · case rate · outpatient · +3 other terms	7	$126	$128	$4	3%	—	$126 – $138
15	Medicaid fee schedule · outpatient · +1 other terms	7	$417	$417	—	—	—	$417 – $417
16	Medica fee schedule · outpatient · +3 other terms	5	$130	$96	$24	25%	—	$71 – $130
17	Tricare facility · fee schedule · outpatient · +1 other terms	5	$50k	$35.8k	$22.5k	63%	—	$225 – $50k
18	Kaiser fee schedule · outpatient · +1 other terms	4	$362	$361	$106	29%	—	$152 – $523
19	Oscar professional · percent of total billed charges · outpatientfrom % of charges	4	$89	$89	—	—	—	$89 – $89
20	Wellmark facility · case rate · outpatient	3	$512	$450	$142	32%	—	$209 – $566
21	Excellus fee schedule · outpatient · +4 other terms	2	$102	$102	$95	93%	—	$27 – $224
22	Phcs facility · percent of total billed charges · inpatientfrom % of charges · +3 other terms	2	$191	$191	—	—	—	$191 – $191
23	Bcbs Id professional · fee schedule · outpatient	1	$154	$154	—	—	—	$154 – $154
24	Bcbs Mn fee schedule · outpatient	1	$345	$345	—	—	—	$345 – $345
25	Bcbs Nv fee schedule · outpatient	1	$86	$86	—	—	—	$86 – $86

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