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
Onlay cst nbl mtl 2 surfaces
Low
$1
Average
$1.2k
Median
$864
High
$4.9k
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Prices here combine facility and professional fees. See them separately →Experimental
Reflects negotiated fee schedule rates with commercial payers.
Showing only prices reported under the fee schedule methodology. Choose another in the filter above to change the chart. 193 hospitals; the 90th percentile is 9.1× 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.
Click a bar to filter the hospitals table to that price range.
| # | Hospital | ||||||
|---|---|---|---|---|---|---|---|
| 1 | St. Anthony Shawnee Hospital, Inc Shawnee, OK | $551 | $551 | — | — | — | $551 – $551 |
| 2 | Mayo Regional Hospital Dover Foxcroft, ME | $499 | $553 | $268 | 48% | — | $302 – $1.0k |
| 3 | Baptist Medical Center of the Beaches, INC Beach, FL | $273 | $273 | — | — | — | $273 – $273 |
| 4 | Westfield Memorial Hospital Inc WESTFIELD, NY | $580 | $544 | $129 | 24% | — | $295 – $723 |
| 5 | Gundersen Luthern Medical Center Inc La Crosse, WI | $173 | $994 | $1.7k | 166% | — | $173 – $5.6k |
| 6 | Spohn Hospital Beeville Beeville, TX | $737 | $737 | — | — | — | $737 – $737 |
| 7 | Spohn Hospital Alice Alice, TX | $737 | $737 | — | — | — | $737 – $737 |
| 8 | OSF Saint Francis Medical Center Peoria, IL | $412 | $412 | — | — | — | $412 – $412 |
| 9 | Covenant Medical Center Lubbock, TX | $2.0k | $2.0k | — | — | — | $2.0k – $2.0k |
| 10 | Corewell Health Butterworth Hospital Grand Rapids, MI | $404 | $403 | $83 | 21% | — | $292 – $512 |
Ask Claude or any MCP client for HCPCS D6614 pricing at a specific hospital — see how to connect.