HCPCS D9954

Dental appliance fabrication and delivery

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

Fab/del oral appliance thxpy

Payer pricing summary

Low

$51

Average

$394

Median

$219

High

$1.2k

Payer rate distribution

Filter by billing methodology

All methodologies Case rate 13 Fee schedule 9 Per diem 0 Percent of billed charges 10 Other 5

Filter by billing class

#
1	Molina facility · case rate · outpatient · +4 other terms	28	$87	$132	$81	61%	—	$37 – $338
2	Blue Cross Blue Shield facility · fee schedule · outpatient · +3 other terms	19	$704	$651	$121	19%	—	$496 – $1.0k
3	UnitedHealthcare facility · case rate · outpatient · +4 other terms	17	$55	$68	$33	48%	—	$37 – $176
4	Anthem facility · case rate · outpatient · +3 other terms	15	$52	$57	$13	23%	—	$36 – $89
5	Caresource facility · case rate · outpatient · +2 other terms	15	$53	$57	$13	23%	—	$36 – $90
6	Optum facility · case rate · outpatient · +1 other terms	13	$50	$71	$42	59%	—	$44 – $167
7	Aetna Better Health facility · case rate · outpatient · +1 other terms	6	$211	$211	—	—	—	$211 – $211
8	Amerihealth Caritas facility · case rate · outpatient · +1 other terms	6	$193	$193	—	—	—	$193 – $193
9	Aetna facility · case rate · outpatient · +4 other terms	5	$211	$227	$53	23%	—	$176 – $338
10	Humana facility · case rate · outpatient · +2 other terms	5	$176	$183	$9	5%	—	$176 – $193
11	Medicaid facility · case rate · outpatient	2	$176	$176	—	—	—	$176 – $176
12	Wellmark facility · case rate · outpatient	2	$433	$433	$200	46%	—	$234 – $633
13	Bcbs Id professional · fee schedule · outpatient	1	$75	$75	—	—	—	$75 – $75
14	Bcbs Mn fee schedule · outpatient	1	$704	$704	—	—	—	$704 – $704
15	Cigna percent of total billed charges · bothfrom % of charges · +1 other terms	1	$2.0k	$2.0k	—	—	—	$2.0k – $2.0k
16	Highmark fee schedule · outpatient · +1 other terms	1	$152	$152	$63	42%	—	$107 – $242
17	MultiPlan percent of total billed charges · bothfrom % of charges · +1 other terms	1	$1.9k	$1.9k	—	—	—	$1.9k – $1.9k
18	Oscar professional · percent of total billed charges · outpatientfrom % of charges	1	$51	$51	—	—	—	$51 – $51
19	Tricare percent of total billed charges · bothfrom % of charges	1	$1.2k	$1.2k	—	—	—	$1.2k – $1.2k
20	WellCare facility · case rate · outpatient	1	$176	$176	—	—	—	$176 – $176