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
I/D Abs Submax/Ln Intraoral Pf
Perryville, MO
See all hospitals reporting CPT 42310 →Price type
Mercy Perry’s median price of $391 is 39% below the median hospital's median price ($639), higher than 17% of the 1,541 hospitals reporting CPT 42310. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 16 payers, 29 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 | Medicaid hb wash jefn linc samc pcmh stod il medicaid facility · percent of total billed charges · outpatientfrom % of charges | $84 | $84 | — | — | — | $84 – $84 |
| 2 | Blue Cross Blue Shield hb pcmh medicare/managed mcr w/seq 98.1% facility · percent of total billed charges · outpatientfrom % of charges | $170 | $170 | — | — | — | $170 – $170 |
| 3 | Humana hb pcmh medicare/managed mcr w/seq 98.1% facility · percent of total billed charges · outpatientfrom % of charges | $170 | $170 | — | — | — | $170 – $170 |
| 4 | Medica hb pcmh medicare/managed mcr w/seq 98.1% facility · percent of total billed charges · outpatientfrom % of charges | $170 | $170 | — | — | — | $170 – $170 |
| 5 | Medicare hb pcmh medicare/managed mcr w/seq 98.1% facility · percent of total billed charges · outpatientfrom % of charges | $170 | $170 | — | — | — | $170 – $170 |
| 6 | UnitedHealthcare hb pcmh medicare/managed mcr w/seq 98.1% facility · percent of total billed charges · outpatientfrom % of charges | $170 | $170 | — | — | — | $170 – $170 |
| 7 | WellCare hb pcmh medicare/managed mcr w/seq 98.1% facility · percent of total billed charges · outpatientfrom % of charges | $170 | $170 | — | — | — | $170 – $170 |
| 8 | UnitedHealthcare hb pcmh uhc medicare w/o seq facility · percent of total billed charges · outpatientfrom % of charges | $173 | $173 | — | — | — | $173 – $173 |
| 9 | Aetna hb pcmh aetna/coventry medicare 102% w/o seq facility · percent of total billed charges · outpatientfrom % of charges | $177 | $177 | — | — | — | $177 – $177 |
| 10 | Devoted hb pcmh devoted health medicare advantage 104% w/seq facility · percent of total billed charges · outpatientfrom % of charges | $177 | $177 | — | — | — | $177 – $177 |
| 11 | Tricare hb pcmh tricare facility · percent of total billed charges · outpatientfrom % of charges | $203 | $203 | — | — | — | $203 – $203 |
| 12 | Medica hb linc pcmh medica exchange new 010122 facility · percent of total billed charges · outpatientfrom % of charges | $235 | $235 | — | — | — | $235 – $235 |
| 13 | Ambetter hb pcmh ambetter exchange facility · percent of total billed charges · outpatientfrom % of charges | $265 | $265 | — | — | — | $265 – $265 |
| 14 | Blue Cross Blue Shield hb stlo wash jefn linc samc cape stod pcmh bcbs ascension facility · percent of total billed charges · outpatientfrom % of charges | $266 | $266 | — | — | — | $266 – $266 |
| 15 | UnitedHealthcare hb pcmh uhc core facility · percent of total billed charges · outpatientfrom % of charges | $319 | $319 | — | — | — | $319 – $319 |
| 16 | Blue Cross Blue Shield hb pcmh anthem blue preferred facility · percent of total billed charges · outpatientfrom % of charges | $347 | $347 | — | — | — | $347 – $347 |
| 17 | Blue Cross Blue Shield hb pcmh anthem pathway/exchange facility · percent of total billed charges · outpatientfrom % of charges | $347 | $347 | — | — | — | $347 – $347 |
| 18 | Aetna hb pcmh linc aetna coventry all products facility · percent of total billed charges · outpatientfrom % of charges | $366 | $366 | — | — | — | $366 – $366 |
| 19 | First Health hb pcmh linc aetna coventry all products facility · percent of total billed charges · outpatientfrom % of charges | $366 | $366 | — | — | — | $366 – $366 |
| 20 | Optum hb pcmh uhc all payer exchange facility · percent of total billed charges · outpatientfrom % of charges | $369 | $369 | — | — | — | $369 – $369 |
| 21 | UnitedHealthcare hb pcmh uhc all payer exchange facility · percent of total billed charges · outpatientfrom % of charges | $369 | $369 | — | — | — | $369 – $369 |
| 22 | Anthem hb pcmh anthem blue access facility · percent of total billed charges · outpatientfrom % of charges | $391 | $391 | — | — | — | $391 – $391 |
| 23 | Blue Cross Blue Shield hb pcmh anthem blue access facility · percent of total billed charges · outpatientfrom % of charges | $391 | $391 | — | — | — | $391 – $391 |
| 24 | Cigna hb pcmh cigna facility · percent of total billed charges · outpatientfrom % of charges | $416 | $416 | — | — | — | $416 – $416 |
| 25 | Blue Cross Blue Shield hb pcmh anthem traditional facility · percent of total billed charges · outpatientfrom % of charges | $430 | $430 | — | — | — | $430 – $430 |
Last updated: Mar 12, 2026
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