Gingivectomy/plasty rest at SSM-SLUH, Inc.

Saint Louis, MO

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Pricing by billing methodology

Price type

How this price compares nationally

SSM-SLUH, Inc.’s median price of $225 is 94% below the median hospital's median price ($3.6k), higher than 3% of the 614 hospitals reporting HCPCS D4212. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS D4212 at SSM-SLUH, Inc.

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	$117	$133	$50	37%	—	$71 – $222
2	Blue Cross Blue Shield anthem blue preferred hmo/pos fee schedule · outpatient	$120	$136	$51	37%	—	$73 – $227
3	Blue Cross Blue Shield anthem blue access choice all commercial plans fee schedule · outpatient	$120	$140	$52	37%	—	$73 – $227
4	Blue Cross Blue Shield anthem blue access ppo fee schedule · outpatient	$173	$167	$65	39%	—	$78 – $245
5	Aetna carelink all commercial plans fee schedule · outpatient	$2.2k	$2.2k	—	—	—	$2.2k – $2.2k
6	Cigna all commercial plans fee schedule · outpatient	$3.0k	$3.0k	—	—	—	$3.0k – $3.0k
7	Blue Cross Blue Shield anthem medicare managed care plan fee schedule · outpatient	$3.3k	$3.3k	—	—	—	$3.3k – $3.3k
8	Aetna medicare managed care plan fee schedule · outpatient	$3.3k	$3.3k	—	—	—	$3.3k – $3.3k
9	Aetna all commercial plans fee schedule · outpatient	$3.4k	$3.4k	—	—	—	$3.4k – $3.4k
10	Humana medicare managed care plan fee schedule · outpatient	$3.4k	$3.4k	—	—	—	$3.4k – $3.4k
11	Aetna advantra medicare managed care plan fee schedule · outpatient	$3.4k	$3.4k	—	—	—	$3.4k – $3.4k
12	Oscar exchange fee schedule · outpatient	$4.0k	$4.0k	—	—	—	$4.0k – $4.0k

Last updated: Apr 1, 2026

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