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
DENTAL REFERRAL-PEDS CLN
Teaneck, NJ
See all hospitals reporting HCPCS D0150 →Price type
Holy Name’s median price of $0 is 100% below the median hospital's median price ($146), higher than 0% of the 760 hospitals reporting HCPCS D0150. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 9 payers, 23 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 | Aetna better health mcd/chip facility · percent of total billed charges · outpatientfrom % of charges | $0 | $0 | — | — | — | $0 – $0 |
| 2 | Aetna golden medicare facility · percent of total billed charges · outpatientfrom % of charges | $0 | $0 | — | — | — | $0 – $0 |
| 3 | Aetna hmo/pos facility · percent of total billed charges · outpatientfrom % of charges | $0 | $0 | — | — | — | $0 – $0 |
| 4 | Aetna medicare prime facility · percent of total billed charges · outpatientfrom % of charges | $0 | $0 | — | — | — | $0 – $0 |
| 5 | Aetna qualified health plans facility · percent of total billed charges · outpatientfrom % of charges | $0 | $0 | — | — | — | $0 – $0 |
| 6 | Aetna whole health facility · percent of total billed charges · outpatientfrom % of charges | $0 | $0 | — | — | — | $0 – $0 |
| 7 | Aetna worker's comp facility · percent of total billed charges · outpatientfrom % of charges | $0 | $0 | — | — | — | $0 – $0 |
| 8 | Ambetter ambetter facility · percent of total billed charges · outpatientfrom % of charges | $0 | $0 | — | — | — | $0 – $0 |
| 9 | Blue Cross Blue Shield indemnity facility · percent of total billed charges · outpatientfrom % of charges | $0 | $0 | — | — | — | $0 – $0 |
| 10 | Blue Cross Blue Shield managed facility · percent of total billed charges · outpatientfrom % of charges | $0 | $0 | — | — | — | $0 – $0 |
| 11 | Blue Cross Blue Shield ppo facility · percent of total billed charges · outpatientfrom % of charges | $0 | $0 | — | — | — | $0 – $0 |
| 12 | Cigna hmo/pos facility · percent of total billed charges · outpatientfrom % of charges | $0 | $0 | — | — | — | $0 – $0 |
| 13 | First Health first health facility · percent of total billed charges · outpatientfrom % of charges | $0 | $0 | — | — | — | $0 – $0 |
| 14 | MultiPlan auto accident medical facility · percent of total billed charges · outpatientfrom % of charges | $0 | $0 | — | — | — | $0 – $0 |
| 15 | MultiPlan multiplan facility · percent of total billed charges · outpatientfrom % of charges | $0 | $0 | — | — | — | $0 – $0 |
| 16 | MultiPlan worker's comp facility · percent of total billed charges · outpatientfrom % of charges | $0 | $0 | — | — | — | $0 – $0 |
| 17 | UnitedHealthcare medicaid facility · percent of total billed charges · outpatientfrom % of charges | $0 | $0 | — | — | — | $0 – $0 |
| 18 | Aetna medicare prime facility · fee schedule · outpatient | $137 | $137 | — | — | — | $137 – $137 |
| 19 | Aetna golden medicare facility · fee schedule · outpatient | $152 | $152 | — | — | — | $152 – $152 |
| 20 | Clover clover facility · fee schedule · outpatient | $152 | $152 | — | — | — | $152 – $152 |
| 21 | UnitedHealthcare medicare facility · fee schedule · outpatient | $152 | $152 | — | — | — | $152 – $152 |
| 22 | WellCare medicare facility · fee schedule · outpatient | $153 | $153 | — | — | — | $153 – $153 |
| 23 | Cigna hmo/pos facility · fee schedule · outpatient | $438 | $438 | — | — | — | $438 – $438 |
Last updated: Nov 10, 2025
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