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
Retain metal FPD noble alloy
Low
$387
Average
$1.8k
Median
$1.4k
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 5.3× 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 · +5 other terms | 29 | $1.5k | $4.8k | $19.5k | 404% | — | $841 – $111.7k |
| 2 | Aetna fee schedule · outpatient · +5 other terms | 21 | $919 | $1.5k | $1.6k | 106% | — | $588 – $8.1k |
| 3 | Blue Cross Blue Shield facility · fee schedule · outpatient · +2 other terms | 20 | $1.8k | $2.3k | $1.1k | 49% | — | $1.5k – $6.4k |
| 4 | UnitedHealthcare professional · fee schedule · outpatient · +6 other terms | 18 | $1.6k | $1.6k | $707 | 45% | — | $381 – $3.7k |
| 5 | Anthem facility · case rate · outpatient · +5 other terms | 16 | $1.5k | $8.2k | $25.9k | 317% | — | $1.3k – $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 | $1.3k | $202 | 16% | — | $799 – $1.4k |
| 8 | Cigna professional · fee schedule · outpatient · +1 other terms | 9 | $353 | $443 | $179 | 41% | — | $353 – $802 |
| 9 | Humana facility · case rate · outpatient · +2 other terms | 8 | $841 | $873 | $41 | 5% | — | $841 – $925 |
| 10 | Aetna Better Health facility · case rate · outpatient | 7 | $1.0k | $1.0k | $13 | 1% | — | $967 – $1.0k |
| 11 | Amerihealth Caritas facility · case rate · outpatient · +1 other terms | 7 | $925 | $937 | $29 | 3% | — | $925 – $1.0k |
| 12 | MultiPlan professional · percent of total billed charges · outpatientfrom % of charges | 4 | $1.4k | $1.4k | — | — | — | $1.4k – $1.4k |
| 13 | Oscar professional · percent of total billed charges · outpatientfrom % of charges | 4 | $407 | $407 | — | — | — | $407 – $407 |
| 14 | Medica fee schedule · outpatient · +2 other terms | 3 | $645 | $645 | — | — | — | $645 – $645 |
| 15 | Wellmark facility · case rate · outpatient | 3 | $3.2k | $2.8k | $887 | 32% | — | $1.3k – $3.5k |
| 16 | Excellus fee schedule · outpatient | 2 | $1.5k | $1.5k | $206 | 14% | — | $934 – $1.6k |
| 17 | Medicaid facility · case rate · outpatient | 2 | $841 | $841 | — | — | — | $841 – $841 |
| 18 | Bcbs Id professional · fee schedule · outpatient | 1 | $1.1k | $1.1k | — | — | — | $1.1k – $1.1k |
| 19 | Bcbs Mn fee schedule · outpatient | 1 | $1.5k | $1.5k | — | — | — | $1.5k – $1.5k |
| 20 | Bcbs Nv fee schedule · outpatient | 1 | $943 | $943 | — | — | — | $943 – $943 |
| 21 | Bcbs Vt professional · fee schedule · outpatient | 1 | $1.4k | $1.4k | — | — | — | $1.4k – $1.4k |
| 22 | Regence facility · fee schedule · outpatient | 1 | $1.7k | $1.7k | — | — | — | $1.7k – $1.7k |
| 23 | WellCare facility · case rate · outpatient | 1 | $841 | $841 | — | — | — | $841 – $841 |
← Hospitals reporting HCPCS D6122 · Snapshot 20261112T181611Z-3fa9fb76