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
Dental onlay porcelin 2 surf
Saint Louis, MO
See all hospitals reporting HCPCS D2642 →Price type
SSM-SLUH, Inc.’s median price of $778 is 45% below the median hospital's median price ($1.4k), higher than 27% of the 450 hospitals reporting HCPCS D2642. 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, 9 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 | Blue Cross Blue Shield anthem medicare managed care plan fee schedule · outpatient | $635 | $635 | — | — | — | $635 – $635 |
| 2 | Aetna medicare managed care plan fee schedule · outpatient | $648 | $648 | — | — | — | $648 – $648 |
| 3 | Humana medicare managed care plan fee schedule · outpatient | $659 | $659 | — | — | — | $659 – $659 |
| 4 | Aetna advantra medicare managed care plan fee schedule · outpatient | $660 | $660 | — | — | — | $660 – $660 |
| 5 | Oscar exchange fee schedule · outpatient | $777 | $777 | — | — | — | $777 – $777 |
| 6 | Blue Cross Blue Shield anthem pathway exchange fee schedule · outpatient | $766 | $867 | $325 | 37% | — | $464 – $1.4k |
| 7 | Blue Cross Blue Shield anthem blue preferred hmo/pos fee schedule · outpatient | $783 | $889 | $331 | 37% | — | $474 – $1.5k |
| 8 | Blue Cross Blue Shield anthem blue access choice all commercial plans fee schedule · outpatient | $783 | $915 | $338 | 37% | — | $474 – $1.5k |
| 9 | Blue Cross Blue Shield anthem blue access ppo fee schedule · outpatient | $1.1k | $1.1k | $421 | 39% | — | $511 – $1.6k |
Last updated: Apr 1, 2026
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