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
Oral/facial photo images
Teaneck, NJ
See all hospitals reporting HCPCS D0350 →Price type
Holy Name’s median price of $104 is 10% above the median hospital's median price ($94), higher than 65% of the 735 hospitals reporting HCPCS D0350. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 5 payers, 6 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 medicare prime facility · fee schedule · outpatient | $93 | $93 | — | — | — | $93 – $93 |
| 2 | Aetna golden medicare facility · fee schedule · outpatient | $104 | $104 | — | — | — | $104 – $104 |
| 3 | Clover clover facility · fee schedule · outpatient | $104 | $104 | — | — | — | $104 – $104 |
| 4 | UnitedHealthcare medicare facility · fee schedule · outpatient | $104 | $104 | — | — | — | $104 – $104 |
| 5 | WellCare medicare facility · fee schedule · outpatient | $105 | $105 | — | — | — | $105 – $105 |
| 6 | Cigna hmo/pos facility · fee schedule · outpatient | $301 | $301 | — | — | — | $301 – $301 |
Last updated: Nov 10, 2025
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