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
Isolation- tooth w rubb dam
Saint Louis, MO
See all hospitals reporting HCPCS D3910 →Price type
SSM-SLUH, Inc.’s median price of $222 is 80% below the median hospital's median price ($1.1k), higher than 9% of the 518 hospitals reporting HCPCS D3910. 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, 12 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 pathway exchange fee schedule · outpatient | $116 | $131 | $49 | 38% | — | $70 – $219 |
| 2 | Blue Cross Blue Shield anthem blue preferred hmo/pos fee schedule · outpatient | $118 | $135 | $50 | 37% | — | $72 – $224 |
| 3 | Blue Cross Blue Shield anthem blue access choice all commercial plans fee schedule · outpatient | $118 | $138 | $51 | 37% | — | $72 – $224 |
| 4 | Blue Cross Blue Shield anthem blue access ppo fee schedule · outpatient | $171 | $165 | $64 | 39% | — | $77 – $242 |
| 5 | Blue Cross Blue Shield anthem medicare managed care plan fee schedule · outpatient | $635 | $635 | — | — | — | $635 – $635 |
| 6 | Aetna medicare managed care plan fee schedule · outpatient | $648 | $648 | — | — | — | $648 – $648 |
| 7 | Humana medicare managed care plan fee schedule · outpatient | $659 | $659 | — | — | — | $659 – $659 |
| 8 | Aetna advantra medicare managed care plan fee schedule · outpatient | $660 | $660 | — | — | — | $660 – $660 |
| 9 | Oscar exchange fee schedule · outpatient | $777 | $777 | — | — | — | $777 – $777 |
| 10 | Aetna carelink all commercial plans fee schedule · outpatient | $2.2k | $2.2k | — | — | — | $2.2k – $2.2k |
| 11 | Cigna all commercial plans fee schedule · outpatient | $3.0k | $3.0k | — | — | — | $3.0k – $3.0k |
| 12 | Aetna all commercial plans fee schedule · outpatient | $3.4k | $3.4k | — | — | — | $3.4k – $3.4k |
Last updated: Apr 1, 2026
See Tooth isolation with rubber dam pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.