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
Replc tth&acrlc mandibular
Low
$166
Average
$986
Median
$594
High
$8.2k
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
30 payers; the 90th percentile is 6.9× 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 | Humana fee schedule · outpatient · +5 other terms | 71 | $1.4k | $1.3k | $729 | 57% | — | $152 – $2.2k |
| 2 | Molina facility · case rate · outpatient · +5 other terms | 29 | $1.5k | $4.4k | $19.6k | 447% | — | $166 – $111.7k |
| 3 | Aetna fee schedule · outpatient · +7 other terms | 25 | $281 | $589 | $668 | 113% | — | $152 – $3.4k |
| 4 | UnitedHealthcare fee schedule · outpatient · +9 other terms | 20 | $528 | $468 | $118 | 25% | — | $152 – $590 |
| 5 | Anthem facility · case rate · outpatient · +5 other terms | 15 | $1.5k | $8.6k | $26.7k | 309% | — | $1.5k – $108.4k |
| 6 | Caresource facility · case rate · outpatient · +1 other terms | 15 | $1.5k | $8.6k | $26.7k | 309% | — | $1.4k – $108.4k |
| 7 | Optum facility · case rate · outpatient · +1 other terms | 13 | $1.4k | $1.2k | $433 | 37% | — | $158 – $1.4k |
| 8 | Blue Cross Blue Shield facility · fee schedule · outpatient · +6 other terms | 11 | $1.1k | $1.0k | $206 | 20% | — | $388 – $1.1k |
| 9 | Highmark fee schedule · outpatient · +1 other terms | 11 | $525 | $527 | $40 | 8% | — | $408 – $919 |
| 10 | Cigna professional · fee schedule · outpatient · +4 other terms | 10 | $352 | $338 | $24 | 7% | — | $286 – $352 |
| 11 | Aetna Better Health facility · case rate · outpatient | 7 | $200 | $199 | $3 | 1% | — | $191 – $200 |
| 12 | Amerihealth Caritas facility · case rate · outpatient · +1 other terms | 7 | $183 | $185 | $6 | 3% | — | $183 – $200 |
| 13 | Medicaid fee schedule · outpatient · +1 other terms | 7 | $1.1k | $1.1k | — | — | — | $1.1k – $1.1k |
| 14 | Kaiser fee schedule · outpatient · +1 other terms | 4 | $651 | $632 | $405 | 64% | — | $152 – $1.1k |
| 15 | MultiPlan percent of total billed charges · outpatientfrom % of charges · +1 other terms | 4 | $912 | $912 | $81 | 9% | — | $798 – $1.0k |
| 16 | Medica fee schedule · outpatient · +2 other terms | 3 | $644 | $644 | — | — | — | $644 – $644 |
| 17 | Wellmark facility · case rate · outpatient | 3 | $634 | $556 | $175 | 32% | — | $258 – $700 |
| 18 | Excellus fee schedule · outpatient · +1 other terms | 2 | $566 | $563 | $77 | 14% | — | $347 – $590 |
| 19 | First Health percent of total billed charges · outpatientfrom % of charges | 2 | $923 | $923 | $11 | 1% | — | $912 – $935 |
| 20 | Bcbs Id professional · fee schedule · outpatient | 1 | $541 | $541 | — | — | — | $541 – $541 |
| 21 | Bcbs Mn fee schedule · outpatient | 1 | $1.1k | $1.1k | — | — | — | $1.1k – $1.1k |
| 22 | Bcbs Nv fee schedule · outpatient | 1 | $389 | $389 | — | — | — | $389 – $389 |
| 23 | Bcbs Ny percent of total billed charges · bothfrom % of charges | 1 | $199 | $199 | — | — | — | $199 – $199 |
| 24 | Bcbs Tx percent of total billed charges · outpatientfrom % of charges | 1 | $289 | $289 | $32 | 11% | — | $257 – $321 |
| 25 | Bcbs Vt professional · fee schedule · outpatient | 1 | $308 | $308 | — | — | — | $308 – $308 |
← Hospitals reporting HCPCS D5671 · Snapshot 20261112T124536Z-e251e855