Adjustment of removable retainer

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.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

Removable retainer adjust

Payers reporting HCPCS D8681

Payer pricing summary

Low

$43

Average

$226

Median

$155

High

$1.3k

Payer rate distribution

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#
1	Molina facility · case rate · outpatient · +5 other terms	29	$89	$135	$81	60%	—	$37 – $338
2	Aetna fee schedule · outpatient · +5 other terms	20	$124	$176	$140	79%	—	$48 – $638
3	Blue Cross Blue Shield facility · fee schedule · outpatient · +4 other terms	20	$330	$365	$148	40%	—	$259 – $939
4	UnitedHealthcare professional · fee schedule · outpatient · +6 other terms	19	$127	$167	$59	35%	—	$81 – $296
5	Anthem facility · case rate · outpatient · +5 other terms	15	$52	$57	$13	23%	—	$36 – $89
6	Caresource facility · case rate · outpatient · +1 other terms	15	$53	$57	$13	23%	—	$36 – $90
7	Optum facility · case rate · outpatient · +1 other terms	13	$50	$71	$42	59%	—	$44 – $167
8	Highmark fee schedule · outpatient · +1 other terms	11	$42	$45	$21	46%	—	$42 – $242
9	Cigna professional · fee schedule · outpatient · +1 other terms	10	$74	$71	$5	7%	—	$64 – $74
10	Humana facility · case rate · outpatient · +2 other terms	8	$176	$182	$9	5%	—	$176 – $193
11	Aetna Better Health facility · case rate · outpatient	7	$211	$208	$9	4%	—	$175 – $211
12	Amerihealth Caritas facility · case rate · outpatient · +1 other terms	7	$193	$196	$6	3%	—	$193 – $211
13	MultiPlan professional · percent of total billed charges · outpatientfrom % of charges	4	$248	$248	—	—	—	$248 – $248
14	Oscar professional · percent of total billed charges · outpatientfrom % of charges	4	$70	$70	—	—	—	$70 – $70
15	Medica fee schedule · outpatient · +2 other terms	3	$134	$134	—	—	—	$134 – $134
16	Wellmark facility · case rate · outpatient	3	$573	$503	$159	32%	—	$234 – $633
17	Medicaid facility · case rate · outpatient	2	$176	$176	—	—	—	$176 – $176
18	Bcbs Id professional · fee schedule · outpatient	1	$141	$141	—	—	—	$141 – $141
19	Bcbs Mn fee schedule · outpatient	1	$271	$271	—	—	—	$271 – $271
20	Bcbs Nv fee schedule · outpatient	1	$75	$75	—	—	—	$75 – $75
21	Bcbs Vt professional · fee schedule · outpatient	1	$124	$124	—	—	—	$124 – $124
22	Regence facility · fee schedule · outpatient	1	$132	$132	—	—	—	$132 – $132
23	WellCare facility · case rate · outpatient	1	$176	$176	—	—	—	$176 – $176