Impression and custom preparation; interim obturator prosthesis Facility (CPT 21079)
21079 is the billing code hospitals use for this service. Prices below are each hospital's own posted facility charge.
Name shown as it appears in hospital billing files.
175 of 4255 hospitals post a price for this code. Hospitals that don't post one are left out. We never guess a number.
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| Hospital | Location | Posted cash | Posted gross | Medicare pays | × Medicare |
|---|---|---|---|---|---|
| Washington County Hospital and Nursing Home | Chatom, AL | $54.17 | — | $2,993.40 | 0.0× |
| Akron Children's Hospital | Akron, OH | $260.25 | $347 | $3,136.68 | 0.1× |
| Children's Hospital Colorado | Aurora, CO | $650 | $1,000 | $3,497.42 | 0.2× |
| Cedar-sinai Marina Del Rey Hospital range across 10 matching MRF lines |
Marina Del Rey, CA | $655.63–$18,447.52 | $1,008.66–$28,380.80 | $4,264.23 | varies |
| Westfield Memorial Hospital, Inc | Westfield, NY | $734.58 | $3,339 | $4,138.63 | 0.2× |
| Unity Health - White County Medical Center | Searcy, AR | $801.50 | $3,206 | $3,018.80 | 0.3× |
| Unity Health - Jacksonville | Jacksonville, AR | $801.50 | $3,206 | $3,115.14 | 0.3× |
| Unity Health - Newport | Newport, AR | $801.50 | $3,206 | $3,018.80 | 0.3× |
| Nacogdoches Memorial Hospital | Nacogdoches, TX | $816 | $2,721 | $3,330.57 | 0.2× |
| Cedars-sinai Medical Center range across 9 matching MRF lines |
Los Angeles, CA | $936.62–$24,184.55 | $1,440.95–$37,207 | $4,264.23 | varies |
| Erie County Medical Center | Buffalo, NY | $954 | $6,173 | $4,138.63 | 0.2× |
| Huntington Hospital range across 9 matching MRF lines |
Pasadena, CA | $1,147.80–$15,116.08 | $1,765.84–$23,255.50 | $4,264.23 | varies |
| East Carroll Parish Hospital | Lake Providence, LA | $1,284.75 | $1,713 | $3,018.60 | 0.4× |
| Concord Hospital | Concord, NH | $1,406.40 | $4,688 | $3,540.10 | 0.4× |
| Concord Hospital – Laconia | Laconia, NH | $1,406.40 | $4,688 | $3,540.10 | 0.4× |
| Concord Hospital – Franklin | Franklin, NH | $1,406.40 | $4,688 | $3,540.10 | 0.4× |
| Torrance Memorial Medical Center range across 7 matching MRF lines |
Torrance, CA | $1,589.98–$31,644.62 | $1,939–$38,591 | $4,264.23 | varies |
| Artesia General Hospital | Artesia, NM | $1,758 | $2,930 | $3,282.20 | 0.5× |
| Bayside Community Hospital | Anahuac, TX | $1,763 | $1,763 | $3,330.57 | 0.5× |
| Karmanos Cancer Center | Detroit, MI | $1,816.20 | $3,632.40 | $3,304.96 | 0.5× |
| Vanderbilt Bedford Hospital range across 2 matching MRF lines |
Shelbyville, TN | $1,874.85–$1,907.04 | $6,465–$6,576 | $3,165.95 | varies |
| Vanderbilt Tullahoma-Harton Hospital range across 2 matching MRF lines |
Tullahoma, TN | $1,874.85–$1,907.04 | $6,465–$6,576 | $3,147.45 | varies |
| Vanderbilt Wilson County Hospital range across 2 matching MRF lines |
Lebanon, TN | $1,874.85–$1,907.04 | $6,465–$6,576 | $3,180.78 | varies |
| John H Stroger Jr Hospital | Chicago, IL | $2,017.40 | $2,882 | $3,552.91 | 0.6× |
| Provident Hospital of Chicago | Chicago, IL | $2,017.40 | $2,882 | $3,552.91 | 0.6× |
| Touro | New Orleans, LA | $2,055.90 | $14,685 | $3,112.09 | 0.7× |
| MetroHealth System | Cleveland, OH | $2,254.16 | $6,440.47 | $3,136.68 | 0.7× |
| University of Illinois Hospital and Clinics | Chicago, IL | $2,294.40 | $7,648 | $3,552.91 | 0.6× |
| Seattle Children's Hospital range across 6 matching MRF lines |
Seattle, WA | $2,613.20–$11,826.50 | $2,613.20–$11,826.50 | $3,850.04 | varies |
| Hurley Medical Center | Flint, MI | $2,676 | $2,676 | $3,303.54 | 0.8× |
| Washington Regional Medical Center | Fayetteville, AR | $2,703 | $3,604 | $3,125.71 | 0.9× |
| Boston Medical Center | Boston, MA | $2,787.75 | $6,195 | $3,973.40 | 0.7× |
| Spanish Peaks Regional Health Center | Walsenburg, CO | $2,803.50 | $3,115 | $3,497.42 | 0.8× |
| Baylor University Medical Center (Baylor Scott & White) | Dallas, TX | $2,803.51 | $4,672.51 | $3,330.57 | 0.8× |
| Baylor Scott and White Medical Center Irving | Irving, TX | $2,803.51 | $4,672.51 | $3,330.57 | 0.8× |
| Baylor Scott and White All Saints Medical Center | Fort Worth, TX | $2,803.51 | $4,672.51 | $3,330.57 | 0.8× |
| Baylor Scott & White Medical Center- Waxahachie | Waxahachie, TX | $2,803.51 | $4,672.51 | $3,330.57 | 0.8× |
| Baylor Scott & White Medical Center Grapevine | Grapevine, TX | $2,803.51 | $4,672.51 | $3,336.05 | 0.8× |
| Baylor Scott and White Medical Center Lake Pointe | Rowlett, TX | $2,803.51 | $4,672.51 | $3,330.57 | 0.8× |
| Baylor Scott & White Heart and Vascular Hospital | Dallas, TX | $2,803.51 | $4,672.51 | $3,330.57 | 0.8× |
| Baylor Scott & White Medical Center - Centennial | Frisco, TX | $2,803.51 | $4,672.51 | $3,330.57 | 0.8× |
| Baylor Regional Medical Center at Plano | Plano, TX | $2,803.51 | $4,672.51 | $3,330.57 | 0.8× |
| The Heart Hospital Baylor Denton | Denton, TX | $2,803.51 | $4,672.51 | $3,330.57 | 0.8× |
| Baylor Scott & White The Heart Hospital Plano | Plano, TX | $2,803.51 | $4,672.51 | $3,330.57 | 0.8× |
| Baylor Scott and White Medical Center Mckinney | Mc Kinney, TX | $2,803.51 | $4,672.51 | $3,330.57 | 0.8× |
| Baylor Scott and White Medical Center Frisco at Pg | Frisco, TX | $2,803.51 | $4,672.51 | $3,330.57 | 0.8× |
| Nebraska Medical Center range across 2 matching MRF lines |
Omaha, NE | $2,848.76–$4,225 | $4,382.70–$6,500 | $3,442.75 | varies |
| Bellevue Medical Center range across 2 matching MRF lines |
Bellevue, NE | $2,848.76–$4,225 | $4,382.70–$6,500 | $3,442.75 | varies |
| DeSoto Regional Health System | Mansfield, LA | $2,908.50 | $4,155 | $3,002.14 | 1.0× |
| Sidney Health Center | Sidney, MT | $2,945.54 | $4,757 | $3,387.27 | 0.9× |
| Harris Health range across 2 matching MRF lines |
Houston, TX | $3,033.94–$5,068 | $5,068 | $3,330.57 | varies |
| Lakeside Medical Center | Belle Glade, FL | $3,255.33 | — | $3,462.26 | 0.9× |
| Lallie Kemp Regional Medical Center | Independence, LA | $3,276.13 | $5,460.21 | $3,002.14 | 1.1× |
| Dallas Medical Center | Dallas, TX | $3,314 | $5,485.73 | $3,330.57 | 1.0× |
| Waverly Health Center | Waverly, IA | $3,326.96 | $6,398 | $3,187.29 | 1.0× |
| St. Joseph's Medical Center | Yonkers, NY | $3,387.27 | — | $4,138.63 | 0.8× |
| Lima Memorial Health System | Lima, OH | $3,433.50 | $3,815 | $3,165.74 | 1.1× |
| Vanderbilt University Hospital range across 2 matching MRF lines |
Nashville, TN | $3,491.10–$3,551.04 | $6,465–$6,576 | $3,254.56 | varies |
| Titus Regional Medical Center | Mount Pleasant, TX | $3,502.20 | $5,837 | $3,330.57 | 1.1× |
| Our Lady of the Lake Surgical Hospital | Slidell, LA | $3,561.05 | — | $3,010.88 | 1.2× |
| University Medical Center New Orleans | New Orleans, LA | $3,586.88 | $16,304 | $3,002.14 | 1.2× |
| CAMC Greenbrier Valley Medical Center | Ronceverte, WV | $3,625 | $3,625 | $3,180.38 | 1.1× |
| Manning Family Children's | New Orleans, LA | $3,660.93 | $13,559 | $3,112.09 | 1.2× |
| UNM Hospital | Albuquerque, NM | $3,747.43 | $6,813.50 | $3,282.20 | 1.1× |
| University Medical Center | Las Vegas, NV | $3,763.50 | $12,545 | $3,624.04 | 1.0× |
| Lincoln Medical & Mental Health Center | Bronx, NY | $3,837.72 | — | $4,138.63 | 0.9× |
| Jacobi Medical Center | Bronx, NY | $3,837.72 | — | $4,138.63 | 0.9× |
| Elmhurst Hospital Center | Elmhurst, NY | $3,837.72 | — | $4,138.63 | 0.9× |
| NYC Health + Hospitals/South Brooklyn Health | Brooklyn, NY | $3,837.72 | — | $4,138.63 | 0.9× |
| Metropolitan Hospital Center | New York, NY | $3,837.72 | — | $4,138.63 | 0.9× |
| Kings County Hospital Center | Brooklyn, NY | $3,837.72 | — | $4,138.63 | 0.9× |
| Bellevue Hospital Center | New York, NY | $3,837.72 | — | $4,138.63 | 0.9× |
| Queens Hospital Center | Jamaica, NY | $3,837.72 | — | $4,138.63 | 0.9× |
| Harlem Hospital Center | New York, NY | $3,837.72 | — | $4,138.63 | 0.9× |
| Woodhull Medical & Mental Health Center | Brooklyn, NY | $3,837.72 | — | $4,138.63 | 0.9× |
| Griffin Hospital | Derby, CT | $3,877.03 | — | $3,974.62 | 1.0× |
| Charleston Area Medical Center | Charleston, WV | $3,919 | $3,919 | $3,180.38 | 1.2× |
| Highland Hospital | Rochester, NY | $3,935.40 | — | $4,138.63 | 1.0× |
| Strong Memorial Hospital | Rochester, NY | $3,935.40 | — | $4,138.63 | 1.0× |
| Valleywise Health Medical Center | Phoenix, AZ | $4,068.55 | — | $3,537.87 | 1.1× |
| Kaleida Health range across 2 matching MRF lines |
Buffalo, NY | $4,128–$9,212 | $4,128–$9,212 | $4,138.63 | varies |
| Nyack Hospital | Nyack, NY | $4,138.63 | — | $4,138.63 | 1.0× |
| Montefiore St. Luke's Cornwall | Newburgh, NY | $4,138.63 | — | $4,138.63 | 1.0× |
| Saint Thomas Hospital for Specialty Surgery | Nashville, TN | $4,145.32 | — | $3,180.78 | 1.3× |
| Northwest Hills Surgical Hospital | Austin, TX | $4,320.72 | $12,002 | $3,330.57 | 1.3× |
| Henry Ford Macomb Hospital | Clinton Township, MI | $4,558.89 | — | $3,303.54 | 1.4× |
| Henry Ford Hospital | Detroit, MI | $4,558.89 | $4,999 | $3,303.54 | 1.4× |
| Henry Ford Wyandotte Hospital | Wyandotte, MI | $4,558.89 | — | $3,303.54 | 1.4× |
| Henry Ford West Bloomfield Hospital | West Bloomfield, MI | $4,558.89 | $4,999 | $3,303.54 | 1.4× |
| Texas Scottish Rite Hospital For Children | Dallas, TX | $4,642 | $4,642 | $3,330.57 | 1.4× |
| Summit Surgical, LLC | Hutchinson, KS | $4,696.04 | $5,870.05 | $3,049.08 | 1.5× |
| Hennepin County Medical Center | Minneapolis, MN | $4,869 | $10,820 | $3,472.43 | 1.4× |
| Dunes Surgical Hospital | Dakota Dunes, SD | $4,928.13 | — | $3,387.27 | 1.5× |
| Omega Hospital range across 2 matching MRF lines |
Metairie, LA | $5,064.54–$22,351.37 | $8,682.06–$38,316.63 | $3,112.09 | varies |
| Memorial Sloan Kettering Cancer Center | New York, NY | $5,130 | $5,130 | $4,138.63 | 1.2× |
| McKenzie County Healthcare Systems Inc | Watford City, ND | $5,153.85 | $7,929 | $3,387.27 | 1.5× |
| Treasure Valley Hospital | Boise, ID | $5,341.42 | — | $3,349.87 | 1.6× |
| Mount Sinai Hospital | New York, NY | $5,670 | $6,300 | $4,138.63 | 1.4× |
| Mount Sinai West | New York, NY | $5,670 | $6,300 | $4,138.63 | 1.4× |
| Mount Sinai Brooklyn | Brooklyn, NY | $5,670 | $6,300 | $4,138.63 | 1.4× |
| Baylor Scott & White Medical Center -taylor | Taylor, TX | $6,174.37 | $10,290.62 | $3,330.57 | 1.9× |
| Scott & White Hospital-round Rock | Round Rock, TX | $6,174.37 | $10,290.62 | $3,330.57 | 1.9× |
| Baylor Scott & White Medical Center - Pflugerville | Pflugerville, TX | $6,174.37 | $10,290.62 | $3,330.57 | 1.9× |
| Baylor Scott & White Medical Center - Buda | Buda, TX | $6,174.37 | $10,290.62 | $3,330.57 | 1.9× |
| Baylor Scott & White Medical Center- Austin | Austin, TX | $6,174.37 | $10,290.62 | $3,330.57 | 1.9× |
| Mercyhealth Fhn Hospital | Freeport, IL | $6,301.60 | $7,877 | $3,552.91 | 1.8× |
| Duncan Regional Hospital, Inc | Duncan, OK | $6,611.96 | — | $3,188.71 | 2.1× |
| Baylor Scott & White Medical Center - Temple | Temple, TX | $7,481.86 | $12,469.76 | $3,330.57 | 2.2× |
| Baylor Scott & White Medical Center - Hillcrest | Waco, TX | $7,481.86 | $12,469.76 | $3,330.57 | 2.2× |
| Baylor Scott & White Medical Center- College Stati | College Station, TX | $7,481.86 | $12,469.76 | $3,330.57 | 2.2× |
| Baylor Scott & White Medical Center - Marble Falls | Marble Falls, TX | $7,481.86 | $12,469.76 | $3,330.57 | 2.2× |
| Baylor Scott & White Hospital Brenham | Brenham, TX | $7,481.86 | $12,469.76 | $3,330.57 | 2.2× |
| OHSU Hospital and Clinics | Portland, OR | $7,776.60 | $11,964 | $3,723.02 | 2.1× |
| Kaiser Foundation Hospital - South San Francisco | South San Francisco, CA | $8,181.60 | $14,610 | $4,813.99 | 1.7× |
| Kaiser Foundation Hospital-santa Clara | Santa Clara, CA | $8,181.60 | $14,610 | $4,792.45 | 1.7× |
| Kaiser Foundation Hospital - Walnut Creek | Walnut Creek, CA | $8,181.60 | $14,610 | $4,707.49 | 1.7× |
| Kaiser Foundation Hospital and Rehab Center | Vallejo, CA | $8,181.60 | $14,610 | $4,870.89 | 1.7× |
| Kaiser Foundation Hospital - Oakland/richmond | Oakland, CA | $8,181.60 | $14,610 | $4,849.96 | 1.7× |
| Kaiser Foundation Hospital - San Francisco | San Francisco, CA | $8,181.60 | $14,610 | $4,792.45 | 1.7× |
| Kaiser Foundation Hospital - Sacramento | Sacramento, CA | $8,181.60 | $14,610 | $4,707.49 | 1.7× |
| Kaiser Foundation Hospital | San Rafael, CA | $8,181.60 | $14,610 | $4,702.61 | 1.7× |
| Kaiser Foundation Hospital - Fremont | Fremont, CA | $8,181.60 | $14,610 | $4,792.45 | 1.7× |
| Kaiser Foundation Hospital - Redwood City | Redwood City, CA | $8,181.60 | $14,610 | $4,813.99 | 1.7× |
| Kaiser Foundation Hospital-san Jose | San Jose, CA | $8,181.60 | $14,610 | $4,876.58 | 1.7× |
| Kaiser Foundation Hosp So Sacramento | Sacramento, CA | $8,181.60 | $14,610 | $4,707.49 | 1.7× |
| Kaiser Foundation Hospital-santa Rosa | Santa Rosa, CA | $8,181.60 | $14,610 | $4,559.13 | 1.8× |
| Kaiser Foundation Hospital - Fresno | Fresno, CA | $8,181.60 | $14,610 | $4,264.23 | 1.9× |
| Kaiser Foundation Hospital Manteca | Manteca, CA | $8,181.60 | $14,610 | $4,645.91 | 1.8× |
| Kaiser Foundation Hospital - Antioch | Antioch, CA | $8,181.60 | $14,610 | $4,681.68 | 1.7× |
| Kaiser Foundation Hospital - Vacaville | Vacaville, CA | $8,181.60 | $14,610 | $4,870.89 | 1.7× |
| Kaiser Foundation Hospital - Roseville | Roseville, CA | $8,181.60 | $14,610 | $4,302.85 | 1.9× |
| Kaiser Foundation Hospital - San Leandro | San Leandro, CA | $8,181.60 | $14,610 | $4,793.05 | 1.7× |
| MUSC Health University Medical Center | Charleston, SC | $8,608.50 | $17,217 | $3,083.64 | 2.8× |
| St. Luke's Magic Valley Medical Center | Twin Falls, ID | $8,795 | $8,795 | $3,456.17 | 2.5× |
| St. Luke's Boise Medical Center | Boise, ID | $8,795 | $8,795 | $3,579.94 | 2.5× |
| St. Luke's Nampa Medical Center | Nampa, ID | $8,795 | $8,795 | $3,349.87 | 2.6× |
| St. Luke's Jerome Medical Center | Jerome, ID | $8,795 | $8,795 | $3,289.92 | 2.7× |
| St. Luke's Elmore Medical Center | Mountain Home, ID | $8,795 | $8,795 | $3,275.49 | 2.7× |
| St. Luke's McCall Medical Center | McCall, ID | $8,795 | $8,795 | $3,275.49 | 2.7× |
| St. Luke's Wood River Medical Center | Ketchum, ID | $8,795 | $8,795 | $3,275.49 | 2.7× |
| Hilton Head Medical Center | Hilton Head Island, SC | $8,912.72 | — | $3,083.64 | 2.9× |
| East Cooper Medical Center | Mount Pleasant, SC | $8,912.72 | — | $3,083.64 | 2.9× |
| Coastal Carolina Medical Center | Hardeeville, SC | $8,912.72 | — | $3,083.64 | 2.9× |
| Baptist Hospital of Miami | Miami, FL | $9,118.20 | $14,028 | $3,462.26 | 2.6× |
| Northwest Surgical Hospital | Oklahoma City, OK | $9,566.13 | — | $3,188.71 | 3.0× |
| Community Hospital, LLC | Oklahoma City, OK | $9,566.13 | — | $3,188.71 | 3.0× |
| Cleveland Clinic | Cleveland, OH | $9,696.70 | $14,918 | $3,136.68 | 3.1× |
| Maimonides Medical Center | Brooklyn, NY | $10,129 | $10,129 | $4,138.63 | 2.4× |
| Roswell Park Comprehensive Cancer Center range across 2 matching MRF lines |
Buffalo, NY | $10,531.17–$11,488.55 | $10,531.17–$11,488.55 | $4,138.63 | varies |
| Montefiore Medical Center | Bronx, NY | $13,452.78 | $20,570 | $4,138.63 | 3.3× |
| Shriners Hospitals For Children | Galveston, TX | $13,878.72 | $13,878.72 | $3,330.57 | 4.2× |
| Alaska Native Medical Center | Anchorage, AK | $14,544 | $14,544 | $3,679.52 | 4.0× |
| Orlando Health Orlando Regional Medical Center | Orlando, FL | $14,900.40 | $37,251 | $3,462.26 | 4.3× |
| Orlando Health - Health Central Hospital | Ocoee, FL | $14,900.40 | $37,251 | $3,462.26 | 4.3× |
| Orlando Health Bayfront Hospital | Saint Petersburg, FL | $14,900.40 | $37,251 | $3,462.26 | 4.3× |
| Orlando Health South Lake Hospital | Clermont, FL | $14,900.40 | $37,251 | $3,462.26 | 4.3× |
| Orlando Health Sebastian River Hospital | Sebastian, FL | $14,900.40 | $37,251 | $3,462.26 | 4.3× |
| Orlando Health Melbourne Hospital | Melbourne, FL | $14,900.40 | $37,251 | $3,462.26 | 4.3× |
| Orlando Health St. Cloud Hospital | Saint Cloud, FL | $14,900.40 | $37,251 | $3,462.26 | 4.3× |
| Shriners Children's Ohio | Dayton, OH | $15,292.70 | $15,292.70 | $3,249.27 | 4.7× |
| Shriners Children’s St. Louis | St. Louis, MO | $15,294.32 | $15,294.32 | $3,320.81 | 4.6× |
| Shriners Children's Greenville | Greenville, SC | $15,469.44 | $15,469.44 | $3,167.77 | 4.9× |
| Shriners Hospital For Children | Chicago, IL | $16,520.20 | $16,520.20 | $3,552.91 | 4.6× |
| Shriners Children's Spokane | Spokane, WA | $17,363.40 | $17,363.40 | $3,694.56 | 4.7× |
| Shriners Hospital For Children - Portland | Portland, OR | $17,819.05 | $17,819.05 | $3,685.21 | 4.8× |
| Shriners Children's Hawaiʻi | Honolulu, HI | $18,329.83 | $18,329.83 | $3,916.70 | 4.7× |
| Shriners Children's Boston | Boston, MA | $19,516.80 | $19,516.80 | $3,973.40 | 4.9× |
| Shriners Hospitals For Children Northern Calif | Sacramento, CA | $21,034.55 | $21,034.55 | $4,302.85 | 4.9× |
| Upstate University Hospital | Syracuse, NY | — | $3,113 | $4,138.63 | — |
| Graham Hospital Association | Canton, IL | — | $4,558.50 | $3,552.91 | — |
| UAB Hospital | Birmingham, AL | — | $6,375 | $3,032.62 | — |
| Ohio State University Hospitals | Columbus, OH | — | $7,518 | $3,266.75 | — |
| James Cancer Hospital & Solove Research Institute | Columbus, OH | — | $7,518 | $3,196.84 | — |
| University of Texas M D Anderson Cancer Center | Houston, TX | — | $14,569 | $3,330.57 | — |
| Phoenix Children’s Hospital – Thomas Campus | Phoenix, AZ | — | $20,559 | $3,537.87 | — |
A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.
"Medicare pays" is the facility (technical) rate, matching the posted facility charge; the doctor's separate professional fee is excluded throughout. "—" means Medicare has no comparable facility rate.