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.
Generation details were not recorded for this description.
Original text from hospital filings
Unlisted procedure, dentoalveolar structures
Jourdanton, TX
Negotiated rates from the hospital’s own file: 8 payers, 38 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 | WellCare mcrhmo fee schedule · outpatient | $250 | $250 | — | — | — | $250 – $250 |
| 2 | WellCare mcrpos fee schedule · outpatient | $250 | $250 | — | — | — | $250 – $250 |
| 3 | WellCare mcrppo fee schedule · outpatient | $250 | $250 | — | — | — | $250 – $250 |
| 4 | WellCare mcrsnp fee schedule · outpatient | $250 | $250 | — | — | — | $250 – $250 |
| 5 | WellCare pffs fee schedule · outpatient | $250 | $250 | — | — | — | $250 – $250 |
| 6 | Blue Cross Blue Shield mybluehealth fee schedule · outpatient | $330 | $330 | — | — | — | $330 – $330 |
| 7 | First Health chip per diem · outpatient | $365 | $365 | — | — | — | $365 – $365 |
| 8 | First Health chipperinate per diem · outpatient | $365 | $365 | — | — | — | $365 – $365 |
| 9 | First Health mcdstar per diem · outpatient | $365 | $365 | — | — | — | $365 – $365 |
| 10 | Blue Cross Blue Shield blueadvantage fee schedule · outpatient | $438 | $438 | — | — | — | $438 – $438 |
| 11 | Blue Cross Blue Shield blueessentials fee schedule · outpatient | $442 | $442 | — | — | — | $442 – $442 |
| 12 | Blue Cross Blue Shield blueessentialsaccess fee schedule · outpatient | $442 | $442 | — | — | — | $442 – $442 |
| 13 | Blue Cross Blue Shield healthselectopenaccess(eposoa) fee schedule · outpatient | $485 | $485 | — | — | — | $485 – $485 |
| 14 | Blue Cross Blue Shield ppo fee schedule · outpatient | $525 | $525 | — | — | — | $525 – $525 |
| 15 | Aetna Better Health chip fee schedule · outpatient | $740 | $740 | — | — | — | $740 – $740 |
| 16 | Aetna Better Health chipepo fee schedule · outpatient | $740 | $740 | — | — | — | $740 – $740 |
| 17 | Aetna Better Health chipperinate fee schedule · outpatient | $740 | $740 | — | — | — | $740 – $740 |
| 18 | Aetna Better Health chpfc fee schedule · outpatient | $740 | $740 | — | — | — | $740 – $740 |
| 19 | Aetna Better Health star fee schedule · outpatient | $740 | $740 | — | — | — | $740 – $740 |
| 20 | Aetna Better Health star+plus fee schedule · outpatient | $740 | $740 | — | — | — | $740 – $740 |
| 21 | Aetna Better Health starkids fee schedule · outpatient | $740 | $740 | — | — | — | $740 – $740 |
| 22 | Aetna qhphix case rate · outpatient | $1.2k | $1.2k | — | — | — | $1.2k – $1.2k |
| 23 | Aetna narrownetwork case rate · outpatient | $1.6k | $1.6k | — | — | — | $1.6k – $1.6k |
| 24 | UnitedHealthcare smallgroup case rate · outpatient | $1.6k | $1.6k | — | — | — | $1.6k – $1.6k |
| 25 | UnitedHealthcare charter case rate · outpatient | $1.6k | $1.6k | — | — | — | $1.6k – $1.6k |