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 SURGERY
Chicago, IL
See all hospitals reporting HCPCS D0484 →Price type
John H. Stroger, Jr. Hospital’s median price of $121 is 16% below the median hospital's median price ($145), higher than 38% of the 230 hospitals reporting HCPCS D0484. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 4 payers, 8 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 | UnitedHealthcare hmo fee schedule · both | $63 | $63 | — | — | — | $63 – $63 |
| 2 | UnitedHealthcare ppo fee schedule · both | $63 | $63 | — | — | — | $63 – $63 |
| 3 | Aetna hmo fee schedule · both | $116 | $116 | — | — | — | $116 – $116 |
| 4 | Aetna ppo fee schedule · both | $116 | $116 | — | — | — | $116 – $116 |
| 5 | Blue Cross Blue Shield ppo fee schedule · both | $126 | $126 | — | — | — | $126 – $126 |
| 6 | Cigna hmo fee schedule · both | $126 | $126 | — | — | — | $126 – $126 |
| 7 | Cigna ppo fee schedule · both | $126 | $126 | — | — | — | $126 – $126 |
| 8 | Blue Cross Blue Shield hmo fee schedule · both | $155 | $155 | — | — | — | $155 – $155 |
Last updated: Apr 1, 2026
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