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
Intraoral con def mod palat
Low
$1
Average
$2.0k
Median
$1.3k
High
$8.2k
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
23 payers; the 90th percentile is 13.7× 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 | Molina facility · case rate · outpatient · +6 other terms | 29 | $1.5k | $5.4k | $19.4k | 357% | — | $201 – $111.7k |
| 2 | Aetna fee schedule · outpatient · +5 other terms | 24 | $800 | $1.7k | $2.0k | 120% | — | $79 – $7.0k |
| 3 | UnitedHealthcare facility · case rate · outpatient · +6 other terms | 18 | $1.5k | $7.3k | $24.6k | 335% | — | $304 – $111.7k |
| 4 | Anthem facility · case rate · outpatient · +5 other terms | 15 | $1.5k | $8.6k | $26.7k | 309% | — | $1.5k – $108.4k |
| 5 | Caresource facility · case rate · outpatient · +1 other terms | 15 | $1.5k | $8.6k | $26.7k | 309% | — | $1.4k – $108.4k |
| 6 | Optum facility · case rate · outpatient · +1 other terms | 13 | $1.4k | $1.4k | $170 | 12% | — | $1.4k – $1.8k |
| 7 | Blue Cross Blue Shield facility · fee schedule · outpatient · +5 other terms | 11 | $2.0k | $1.9k | $1.1k | 60% | — | $455 – $3.9k |
| 8 | Highmark fee schedule · outpatient · +1 other terms | 11 | $951 | $937 | $87 | 9% | — | $310 – $951 |
| 9 | Humana fee schedule · outpatient · +3 other terms | 11 | $1.2k | $1.8k | $1.6k | 90% | — | $389 – $4.8k |
| 10 | Cigna professional · fee schedule · outpatient · +1 other terms | 10 | $284 | $273 | $16 | 6% | — | $249 – $284 |
| 11 | Aetna Better Health facility · case rate · outpatient | 7 | $2.3k | $2.3k | $51 | 2% | — | $2.2k – $2.5k |
| 12 | Amerihealth Caritas facility · case rate · outpatient · +1 other terms | 7 | $2.1k | $2.1k | $67 | 3% | — | $2.1k – $2.3k |
| 13 | Medica fee schedule · outpatient · +2 other terms | 5 | $518 | $731 | $600 | 82% | — | $334 – $1.8k |
| 14 | Wellmark facility · case rate · outpatient | 3 | $8.1k | $7.1k | $2.2k | 32% | — | $3.3k – $9.0k |
| 15 | Medicaid facility · case rate · outpatient | 2 | $1.9k | $1.9k | — | — | — | $1.9k – $1.9k |
| 16 | Bcbs Id professional · fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 17 | Bcbs Mn fee schedule · outpatient | 1 | $2.3k | $2.3k | $1.0k | 44% | — | $818 – $3.3k |
| 18 | Bcbs Nv fee schedule · outpatient | 1 | $293 | $293 | — | — | — | $293 – $293 |
| 19 | Bcbs Vt professional · fee schedule · outpatient | 1 | $1.1k | $1.1k | — | — | — | $1.1k – $1.1k |
| 20 | MultiPlan professional · percent of total billed charges · outpatientfrom % of charges | 1 | $900 | $900 | — | — | — | $900 – $900 |
| 21 | Oscar professional · percent of total billed charges · outpatientfrom % of charges | 1 | $254 | $254 | — | — | — | $254 – $254 |
| 22 | Regence facility · fee schedule · outpatient | 1 | $514 | $514 | — | — | — | $514 – $514 |
| 23 | WellCare facility · case rate · outpatient | 1 | $1.9k | $1.9k | — | — | — | $1.9k – $1.9k |
← Hospitals reporting HCPCS D5959 · Snapshot 20261112T124536Z-e251e855