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
Maxillary guidance prosthesis with guide flange
Low
$658
Average
$3.5k
Median
$4.5k
High
$6.4k
Each hospital's average Aetna rate, under the methodology and billing class chosen below.
9 hospitals; the 90th percentile is 2.7× 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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9 hospital rates
iThe hospitals that file a Aetna 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 | Cleveland Clinic Weston Hospital Nonprofit Corporation Weston, FL facility · case rate · outpatient | 1 | $2.3k | $2.3k | — | — | — | $2.3k – $2.3k |
| 2 | Doctors’ Hospital of Williamsburg Williamsburg, VA fee schedule · outpatient | 1 | $4.5k | $4.5k | — | — | — | $4.5k – $4.5k |
| 3 | INDIAN RIVER MEMORIAL HOSPITAL INC Vero Beach, FL facility · case rate · outpatient | 1 | $2.1k | $2.1k | — | — | — | $2.1k – $2.1k |
| 4 | MARTIN MEMORIAL MEDICAL CENTER INC Port St Lucie, FL facility · case rate · outpatient | 2 | $2.1k | $2.1k | $193 | 9% | — | $1.9k – $2.3k |
| 5 | Riverside Hospital Inc Newport News, VA fee schedule · outpatient | 1 | $4.5k | $4.5k | — | — | — | $4.5k – $4.5k |
| 6 | Riverside Middle Peninsula Hospital, Inc Gloucester, VA fee schedule · outpatient | 1 | $4.5k | $4.5k | — | — | — | $4.5k – $4.5k |
| 7 | SHORE HEALTH SERVICES INC. Onancock, VA fee schedule · outpatient | 1 | $4.6k | $4.6k | — | — | — | $4.6k – $4.6k |
| 8 | The Cleveland Clinic Foundation Brunswick, OH professional · percent of total billed charges · outpatientfrom % of charges | 3 | $6k | $6.4k | $810 | 13% | — | $5.6k – $7.5k |
| 9 | Upstate University Hospital Syracuse, NY facility · percent of total billed charges · outpatientfrom % of charges | 2 | $658 | $658 | $48 | 7% | — | $610 – $706 |
← Payers reporting HCPCS D5909 · Snapshot 20261113T090226Z-3ce6c0b8