Dental teledentistry review visit

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

Teledentistry dent review

Payers reporting HCPCS D9996

Payer pricing summary

Low

Average

$198

Median

$144

High

$1.5k

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	21	$15	$70	$110	156%	—	$8 – $323
3	Blue Cross Blue Shield facility · fee schedule · outpatient · +4 other terms	20	$240	$187	$101	54%	—	$56 – $389
4	UnitedHealthcare facility · case rate · outpatient · +6 other terms	18	$56	$81	$49	61%	—	$37 – $193
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	Cigna professional · fee schedule · outpatient · +1 other terms	8	$12	$12	—	—	—	$12 – $12
9	Humana facility · case rate · outpatient · +2 other terms	8	$176	$182	$9	5%	—	$176 – $193
10	Aetna Better Health facility · case rate · outpatient	7	$211	$208	$9	4%	—	$175 – $211
11	Amerihealth Caritas facility · case rate · outpatient · +1 other terms	7	$193	$196	$6	3%	—	$193 – $211
12	MultiPlan professional · percent of total billed charges · outpatientfrom % of charges	4	$158	$158	—	—	—	$158 – $158
13	Oscar professional · percent of total billed charges · outpatientfrom % of charges	4	$44	$44	—	—	—	$44 – $44
14	Medica fee schedule · outpatient · +2 other terms	3	$22	$22	—	—	—	$22 – $22
15	Wellmark facility · case rate · outpatient	3	$573	$503	$159	32%	—	$234 – $633
16	Excellus fee schedule · outpatient	2	$17	$17	$2	12%	—	$11 – $18
17	Medicaid facility · case rate · outpatient	2	$176	$176	—	—	—	$176 – $176
18	Bcbs Id professional · fee schedule · outpatient	1	$1	$1	—	—	—	$1 – $1
19	Bcbs Mn fee schedule · outpatient	1	$252	$252	—	—	—	$252 – $252
20	Highmark fee schedule · outpatient	1	$152	$152	$63	42%	—	$107 – $242
21	WellCare facility · case rate · outpatient	1	$176	$176	—	—	—	$176 – $176