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
OSSEOUS SURG 1 TO 3 TEETH
Tehachapi, CA
See all hospitals reporting HCPCS D4261 →Price type
Adventist Health Medical Center Tehachapi’s median price of $685 is 81% below the median hospital's median price ($3.5k), higher than 5% of the 673 hospitals reporting HCPCS D4261. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 6 payers, 12 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | Blue Cross Blue Shield tricare blue shield fee schedule · outpatient | $304 | $304 | — | — | — | $304 – $304 |
| 2 | Kaiser kaiser medicare ip/op only fee schedule · outpatient | $304 | $304 | — | — | — | $304 – $304 |
| 3 | Blue Cross Blue Shield blue shield epn- all other plans percent of total billed charges · outpatientfrom % of charges | $471 | $471 | — | — | — | $471 – $471 |
| 4 | Kaiser kaiser ip/op only- all other plans fee schedule · outpatient | $523 | $523 | — | — | — | $523 – $523 |
| 5 | Aetna aetna-all plans percent of total billed charges · outpatientfrom % of charges | $530 | $530 | — | — | — | $530 – $530 |
| 6 | Blue Cross Blue Shield blue shield non-epn percent of total billed charges · outpatientfrom % of charges | $557 | $557 | — | — | — | $557 – $557 |
| 7 | Cigna cigna- all plans percent of total billed charges · outpatientfrom % of charges | $870 | $870 | — | — | — | $870 – $870 |
| 8 | Blue Cross Blue Shield blue cross exchange case rate · outpatient | $992 | $992 | — | — | — | $992 – $992 |
| 9 | Blue Cross Blue Shield blue cross non-mcs- all other plans case rate · outpatient | $1.1k | $1.1k | — | — | — | $1.1k – $1.1k |
| 10 | Kaiser kaiser medi-cal ip/op only fee schedule · outpatient | $1.1k | $1.1k | — | — | — | $1.1k – $1.1k |
| 11 | Medicaid medi-cal fee schedule · outpatient | $1.1k | $1.1k | — | — | — | $1.1k – $1.1k |
| 12 | Oscar oscar health plan- all plans other · outpatient | $5.4k | $5.4k | — | — | — | $5.4k – $5.4k |
Last updated: May 21, 2026
See Bone surgery on one to three teeth pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.