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
OSSEOUS SURG 1 TO 3 TEETH
Omaha, NE
See all hospitals reporting HCPCS D4261 →Price type
Nebraska Medical Center’s median price of $280 is 92% below the median hospital's median price ($3.5k), higher than 2% of the 673 hospitals reporting HCPCS D4261. 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, 10 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 aetna comm - all other plans fee schedule · outpatient | $79 | $79 | — | — | — | $79 – $79 |
| 2 | Molina molina mcr adv percent of total billed charges · outpatientfrom % of charges | $252 | $252 | — | — | — | $252 – $252 |
| 3 | Medica medica comm - all other plans fee schedule · outpatient | $271 | $271 | — | — | — | $271 – $271 |
| 4 | Medica medica elevate fee schedule · outpatient | $271 | $271 | — | — | — | $271 – $271 |
| 5 | Blue Cross Blue Shield bcbs mcr adv percent of total billed charges · outpatientfrom % of charges | $280 | $280 | — | — | — | $280 – $280 |
| 6 | Blue Cross Blue Shield bcbs-all other plans percent of total billed charges · outpatientfrom % of charges | $280 | $280 | — | — | — | $280 – $280 |
| 7 | Medica medica mcaid fee schedule · outpatient | $560 | $560 | — | — | — | $560 – $560 |
| 8 | UnitedHealthcare uhc mcaid fee schedule · outpatient | $560 | $560 | — | — | — | $560 – $560 |
| 9 | Molina molina mcaid - all other plans fee schedule · outpatient | $577 | $577 | — | — | — | $577 – $577 |
| 10 | UnitedHealthcare uhc all payer - all other plans fee schedule · outpatient | $663 | $663 | — | — | — | $663 – $663 |
Last updated: Aug 10, 2026
See Bone surgery on one to three teeth pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.