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
Limited occlusal adjustment
Low
$139
Average
$1.3k
Median
$1.1k
High
$4.1k
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
50 payers; the 90th percentile is 7.7× 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 | Aetna fee schedule · outpatient · +12 other terms | 168 | $831 | $1.3k | $1.1k | 80% | — | $28 – $5.6k |
| 2 | Humana fee schedule · outpatient · +11 other terms | 168 | $772 | $894 | $661 | 74% | — | $46 – $3.7k |
| 3 | UnitedHealthcare fee schedule · outpatient · +15 other terms | 135 | $1.6k | $1.6k | $2.9k | 190% | — | $6 – $48.9k |
| 4 | Blue Cross Blue Shield facility · fee schedule · outpatient · +11 other terms | 103 | $1.6k | $1.6k | $789 | 51% | — | $298 – $4.4k |
| 5 | WellCare fee schedule · outpatient · +4 other terms | 68 | $1.6k | $1.7k | $1.0k | 60% | — | $595 – $3.9k |
| 6 | Cigna fee schedule · outpatient · +11 other terms | 65 | $864 | $1.5k | $1.4k | 97% | — | $616 – $7.5k |
| 7 | Molina fee schedule · outpatient · +6 other terms | 58 | $1.6k | $1.3k | $558 | 44% | — | $107 – $2.7k |
| 8 | Ambetter facility · fee schedule · outpatient · +1 other terms | 48 | $1.4k | $2.5k | $1.3k | 53% | — | $822 – $4.3k |
| 9 | Anthem facility · fee schedule · outpatient · +6 other terms | 43 | $1.6k | $2.7k | $2.2k | 82% | — | $16 – $7.7k |
| 10 | Devoted fee schedule · outpatient · +3 other terms | 34 | $1.7k | $1.1k | $561 | 51% | — | $601 – $1.8k |
| 11 | Kaiser fee schedule · outpatient · +2 other terms | 26 | $1.1k | $1.0k | $681 | 67% | — | $61 – $2.8k |
| 12 | Bcbs Tx fee schedule · outpatient · +1 other terms | 23 | $1.6k | $1.6k | $46 | 3% | — | $1.6k – $1.7k |
| 13 | Clover fee schedule · outpatient · +2 other terms | 21 | $1.8k | $1.4k | $581 | 40% | — | $584 – $2.0k |
| 14 | Optum facility · fee schedule · outpatient · +5 other terms | 21 | $1.5k | $1.5k | $259 | 17% | — | $787 – $2.0k |
| 15 | Oscar facility · fee schedule · outpatient · +3 other terms | 21 | $945 | $1.3k | $568 | 45% | — | $827 – $2.7k |
| 16 | Regence facility · fee schedule · outpatient · +2 other terms | 21 | $693 | $1.6k | $1.8k | 112% | — | $655 – $6.8k |
| 17 | Baylor Scott White Health Plan facility · fee schedule · outpatient | 15 | $617 | $617 | $0 | 0% | — | $617 – $618 |
| 18 | Caresource facility · case rate · outpatient · +3 other terms | 15 | $53 | $57 | $13 | 23% | — | $36 – $90 |
| 19 | MultiPlan fee schedule · outpatient · +6 other terms | 14 | $1.4k | $1.4k | — | — | — | $1.4k – $1.4k |
| 20 | Highmark fee schedule · outpatient · +2 other terms | 13 | $1.4k | $1.4k | $1.2k | 83% | — | $107 – $4.1k |
| 21 | Superior Healthplan facility · fee schedule · outpatient · +1 other terms | 13 | $682 | $682 | $0 | 0% | — | $682 – $683 |
| 22 | Bcbs Nj fee schedule · outpatient | 12 | $1.9k | $3.9k | $2.6k | 67% | — | $1.8k – $8.0k |
| 23 | Tricare fee schedule · outpatient · +3 other terms | 12 | $587 | $684 | $113 | 16% | — | $587 – $839 |
| 24 | Medica facility · fee schedule · outpatient · +3 other terms | 10 | $1.6k | $1.2k | $760 | 64% | — | $14 – $1.8k |
| 25 | Ucare facility · fee schedule · outpatient | 10 | $1.6k | $1.3k | $437 | 33% | — | $705 – $1.8k |
← Hospitals reporting HCPCS D9951 · Snapshot 20261112T124536Z-e251e855