Adult dental cleaning (prophylaxis) at MVHS, Inc.

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.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

HC Prophylaxis - Adult

Utica, NY

See all hospitals reporting HCPCS D1110 →

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Pricing by billing methodology

Price type

How this price compares nationally

MVHS, Inc.’s median price of $166 is 15% above the median hospital's median price ($144), higher than 70% of the 805 hospitals reporting HCPCS D1110. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS D1110 at MVHS, Inc.

Negotiated rates from the hospital’s own file: 11 payers, 21 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	Excellus excellus bcbs medicaid percent of total billed charges · outpatientfrom % of charges	$41	$41	—	—	—	$41 – $41
2	UnitedHealthcare uhc empire plan percent of total billed charges · bothfrom % of charges	$62	$62	—	—	—	$62 – $62
3	Aetna aetna commercial percent of total billed charges · bothfrom % of charges	$92	$92	—	—	—	$92 – $92
4	Humana humana hmo/pos percent of total billed charges · inpatientfrom % of charges	$101	$101	—	—	—	$101 – $101
5	Bcbs Ny excellus bcbs indemnity percent of total billed charges · bothfrom % of charges	$106	$106	—	—	—	$106 – $106
6	Blue Cross Blue Shield excellus bcbs hmo/ppo percent of total billed charges · bothfrom % of charges	$106	$106	—	—	—	$106 – $106
7	Excellus excellus bcbs hmo/ppo percent of total billed charges · bothfrom % of charges	$106	$106	—	—	—	$106 – $106
8	Excellus excellus bcbs indemnity percent of total billed charges · bothfrom % of charges	$106	$106	—	—	—	$106 – $106
9	Cigna mvp and cigna commercial percent of total billed charges · inpatientfrom % of charges	$110	$110	—	—	—	$110 – $110
10	Humana humana hmo/pos percent of total billed charges · outpatientfrom % of charges	$116	$116	—	—	—	$116 – $116
11	Humana humana military other · outpatient	$145	$145	—	—	—	$145 – $145
12	Tricare humana military other · outpatient	$145	$145	—	—	—	$145 – $145
13	Excellus excellus bcbs medicare advantage other · outpatient	$166	$166	—	—	—	$166 – $166
14	Humana humana medicare advantage other · outpatient	$166	$166	—	—	—	$166 – $166
15	Medicare medicare other · outpatient	$166	$166	—	—	—	$166 – $166
16	Optum vaccn optum other · outpatient	$166	$166	—	—	—	$166 – $166
17	UnitedHealthcare uhc medicare advantage other · outpatient	$168	$168	—	—	—	$168 – $168
18	Aetna aetna medicare advantage other · outpatient	$170	$170	—	—	—	$170 – $170
19	WellCare wellcare medicare advantage other · outpatient	$171	$171	—	—	—	$171 – $171
20	Cigna mvp and cigna commercial other · outpatient	$477	$477	—	—	—	$477 – $477
21	UnitedHealthcare uhc commercial case rate · inpatient	$2.6k	$2.6k	—	—	—	$2.6k – $2.6k

Last updated: Aug 7, 2026

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