FLUORIDE APPLICATOR

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.

Generation details were not recorded for this description.

Original text from hospital filings

Fluoride applicator

Payers reporting HCPCS D5986

Payer pricing summary

Low

Average

$145

Median

$127

High

$580

Payer rate distribution

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#
1	Humana fee schedule · outpatient · +8 other terms	70	$337	$300	$158	53%	—	$56 – $492
2	Molina facility · case rate · outpatient · +6 other terms	30	$107	$134	$79	59%	—	$37 – $338
3	Aetna fee schedule · outpatient · +9 other terms	25	$58	$156	$150	96%	—	$37 – $686
4	UnitedHealthcare professional · fee schedule · outpatient · +9 other terms	24	$99	$138	$57	41%	—	$76 – $236
5	Anthem professional · fee schedule · outpatient · +6 other terms	16	$89	$125	$61	49%	—	$61 – $270
6	Caresource facility · case rate · outpatient · +1 other terms	15	$53	$57	$13	23%	—	$36 – $90
7	Baylor Scott White Health Plan facility · percent of total billed charges · outpatientfrom % of charges	14	$107	$107	$9	8%	—	$99 – $116
8	Optum facility · case rate · outpatient · +3 other terms	14	$51	$72	$41	57%	—	$44 – $167
9	Ambetter facility · percent of total billed charges · outpatientfrom % of charges	13	$130	$130	—	—	—	$130 – $130
10	Superior Healthplan facility · percent of total billed charges · outpatientfrom % of charges	13	$30	$30	$9	32%	—	$16 – $56
11	Blue Cross Blue Shield facility · fee schedule · outpatient · +10 other terms	11	$292	$302	$29	10%	—	$292 – $389
12	Highmark fee schedule · outpatient · +1 other terms	11	$125	$126	$11	9%	—	$107 – $242
13	Cigna professional · fee schedule · outpatient · +6 other terms	10	$71	$69	$4	6%	—	$61 – $71
14	Aetna Better Health facility · case rate · outpatient	7	$211	$208	$9	4%	—	$175 – $211
15	Amerihealth Caritas facility · case rate · outpatient · +3 other terms	7	$193	$196	$6	3%	—	$193 – $211
16	Medica fee schedule · outpatient · +3 other terms	5	$130	$108	$22	20%	—	$83 – $130
17	MultiPlan professional · percent of total billed charges · outpatientfrom % of charges · +3 other terms	5	$180	$178	$5	3%	—	$168 – $180
18	Oscar professional · percent of total billed charges · outpatientfrom % of charges	4	$51	$51	—	—	—	$51 – $51
19	Wellmark facility · case rate · outpatient	3	$573	$503	$159	32%	—	$234 – $633
20	Excellus fee schedule · outpatient · +2 other terms	2	$86	$86	$12	13%	—	$53 – $90
21	Medicaid facility · case rate · outpatient	2	$176	$176	—	—	—	$176 – $176
22	Phcs facility · percent of total billed charges · inpatientfrom % of charges · +1 other terms	2	$65	$65	—	—	—	$65 – $65
23	Tricare facility · fee schedule · outpatient	2	$77	$77	—	—	—	$77 – $77
24	Bcbs Id professional · fee schedule · outpatient	1	$1	$1	—	—	—	$1 – $1
25	Bcbs Mn fee schedule · outpatient	1	$292	$292	—	—	—	$292 – $292

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