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
Repair/reline occlusal guard
Low
$1
Average
$222
Median
$171
High
$886
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Prices here combine facility and professional fees. See them separately →Experimental
Showing prices across every billing methodology. Pick one in the filter above to narrow the chart. 228 hospitals; the 90th percentile is 7.6× 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 | $95 | $95 | — | — | — | $95 – $95 |
| 2 | Mayo Regional Hospital Dover Foxcroft, ME | $65 | $71 | $19 | 26% | — | $53 – $100 |
| 3 | Baptist Medical Center of the Beaches, INC Beach, FL | $193 | $195 | $12 | 6% | — | $176 – $211 |
| 4 | Westfield Memorial Hospital Inc WESTFIELD, NY | $78 | $80 | $19 | 24% | — | $52 – $118 |
| 5 | Gundersen Luthern Medical Center Inc La Crosse, WI | $123 | $136 | $34 | 25% | — | $102 – $211 |
| 6 | Spohn Hospital Beeville Beeville, TX | $119 | $119 | — | — | — | $119 – $119 |
| 7 | Spohn Hospital Alice Alice, TX | $119 | $119 | — | — | — | $119 – $119 |
| 8 | OSF Saint Francis Medical Center Peoria, IL | $65 | $65 | — | — | — | $65 – $65 |
| 9 | Covenant Medical Center Lubbock, TX | $319 | $319 | — | — | — | $319 – $319 |
| 10 | Corewell Health Butterworth Hospital Grand Rapids, MI | $101 | $100 | $21 | 21% | — | $73 – $127 |
Ask Claude or any MCP client for HCPCS D9942 pricing at a specific hospital — see how to connect.