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
Peridontal medicament
Low
$219
Average
$303
Median
$329
High
$334
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4 hospital rates
iThe hospitals that file a Blue Cross Blue Shield 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 | ALBANY MEDICAL CENTER HOSPITAL Albany, NY facility · case rate · outpatient | 4 | $253 | $327 | $121 | 37% | — | $211 – $474 |
| 2 | COLUMBIA MEMORIAL HOSPITAL Hudson, NY facility · case rate · outpatient | 3 | $390 | $330 | $85 | 26% | — | $211 – $390 |
| 3 | GLENS FALLS HOSPITAL INC Falls, NY facility · case rate · outpatient | 1 | $219 | $219 | — | — | — | $219 – $219 |
| 4 | Saratoga Hospital Saratoga Springs, NY facility · case rate · outpatient | 3 | $395 | $334 | $86 | 26% | — | $213 – $395 |
← Payers reporting HCPCS D5994 · Snapshot 20261112T181611Z-3fa9fb76