Custom oral surgery splint at AMH Cath Labs LLC

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

IMPRES&PREP ORAL SURG SPLINT

Arlington, TX

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Pricing by billing methodology

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How this price compares nationally

AMH Cath Labs LLC’s median price of $248 is 47% below the median hospital's median price ($472), higher than 20% of the 1,478 hospitals reporting CPT 21085. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting CPT 21085 at AMH Cath Labs LLC

Negotiated rates from the hospital’s own file: 6 payers, 19 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 managed medicaid fee schedule · outpatient	$88	$88	—	—	—	$88 – $88
2	UnitedHealthcare managed medicaid fee schedule · outpatient	$88	$88	—	—	—	$88 – $88
3	WellCare managed medicaid fee schedule · outpatient	$92	$92	—	—	—	$92 – $92
4	Molina managed medicaid fee schedule · outpatient	$95	$95	—	—	—	$95 – $95
5	Aetna managed medicaid fee schedule · outpatient	$96	$96	—	—	—	$96 – $96
6	Blue Cross Blue Shield exchange case rate · outpatient	$118	$118	—	—	—	$118 – $118
7	Blue Cross Blue Shield medicare advantage case rate · outpatient	$238	$238	—	—	—	$238 – $238
8	Blue Cross Blue Shield hmo case rate · outpatient	$242	$242	—	—	—	$242 – $242
9	Humana medicare advantage case rate · outpatient	$248	$248	—	—	—	$248 – $248
10	Humana medicare advantage ppo case rate · outpatient	$248	$248	—	—	—	$248 – $248
11	Molina medicare advantage case rate · outpatient	$250	$250	—	—	—	$250 – $250
12	WellCare medicare advantage hmo case rate · outpatient	$250	$250	—	—	—	$250 – $250
13	WellCare medicare advantage mmp case rate · outpatient	$262	$262	—	—	—	$262 – $262
14	UnitedHealthcare medicare advantage ppo case rate · outpatient	$265	$265	—	—	—	$265 – $265
15	Blue Cross Blue Shield ppo case rate · outpatient	$269	$269	—	—	—	$269 – $269
16	UnitedHealthcare medicare advantage hmo case rate · outpatient	$269	$269	—	—	—	$269 – $269
17	Blue Cross Blue Shield traditional case rate · outpatient	$860	$860	—	—	—	$860 – $860
18	UnitedHealthcare all payer case rate · outpatient	$1.2k	$1.2k	—	—	—	$1.2k – $1.2k
19	UnitedHealthcare ppo case rate · outpatient	$1.6k	$1.6k	—	—	—	$1.6k – $1.6k

Last updated: Apr 21, 2026

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