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
IMPRES&PREP ORAL SURG SPLINT
Ord, NE
See all hospitals reporting CPT 21085 →Price type
Valley County Hospital’s median price of $594 is 26% above the median hospital's median price ($472), higher than 60% of the 1,478 hospitals reporting CPT 21085. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 8 payers, 13 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 | Bcbs Ne medicare advantage professional · fee schedule · both | $399 | $399 | — | — | — | $399 – $399 |
| 2 | Medica medicare advantage professional · fee schedule · both | $399 | $399 | — | — | — | $399 – $399 |
| 3 | UnitedHealthcare medicare advantage professional · fee schedule · both | $399 | $399 | — | — | — | $399 – $399 |
| 4 | Humana medicare advantage professional · fee schedule · both | $407 | $407 | — | — | — | $407 – $407 |
| 5 | WellCare medicare advantage/dual needs plan professional · fee schedule · both | $411 | $411 | — | — | — | $411 – $411 |
| 6 | Aetna medicare advantage professional · fee schedule · both | $419 | $419 | — | — | — | $419 – $419 |
| 7 | Medica individual and family business plans professional · fee schedule · both | $768 | $768 | — | — | — | $768 – $768 |
| 8 | Bcbs Ne commercial professional · case rate · both | $803 | $803 | — | — | — | $803 – $803 |
| 9 | Medica commercial plans/care system products professional · fee schedule · both | $808 | $808 | — | — | — | $808 – $808 |
| 10 | UnitedHealthcare managed medicaid professional · fee schedule · both | $930 | $930 | — | — | — | $930 – $930 |
| 11 | Molina managed medicaid/chip professional · fee schedule · both | $939 | $939 | — | — | — | $939 – $939 |
| 12 | Molina dual eligible plan professional · fee schedule · both | $957 | $957 | — | — | — | $957 – $957 |
| 13 | MultiPlan primary/complementary ppo professional · fee schedule · both | $1.3k | $1.3k | — | — | — | $1.3k – $1.3k |
Last updated: Jun 15, 2026
See Custom oral surgery splint pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.