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
Non-auto graft addl tooth
Isle, ME
See all hospitals reporting HCPCS D4285 →Price type
The Aroostook Medical Center’s median price of $161 is 71% below the median hospital's median price ($554), higher than 22% of the 165 hospitals reporting HCPCS D4285. 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, 6 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 | Cigna commercial professional · fee schedule · outpatient | $132 | $132 | — | — | — | $132 – $132 |
| 2 | Anthem commercial professional · fee schedule · outpatient | $137 | $137 | — | — | — | $137 – $137 |
| 3 | Anthem enhanced pathways professional · fee schedule · outpatient | $137 | $137 | — | — | — | $137 – $137 |
| 4 | Aetna commercial professional · fee schedule · outpatient | $184 | $184 | — | — | — | $184 – $184 |
| 5 | Aetna mcr advantage professional · fee schedule · outpatient | $184 | $184 | — | — | — | $184 – $184 |
| 6 | UnitedHealthcare commercial professional · fee schedule · outpatient | $197 | $197 | — | — | — | $197 – $197 |
Last updated: Mar 30, 2026
See Non-automatic additional tooth graft pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.