Pr unlisted procedure maxillofacial prosthetic procedure (insertion of surgical guards) (CPT 21089)
21089 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.
51 of 2110 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 | Cash price | Gross charge | Medicare pays | × Medicare |
|---|---|---|---|---|---|
| Washington County Hospital and Nursing Home | Chatom, AL | $54.17 | — | $204.13 | 0.3× |
| Connecticut Children's Medical Center | Hartford, CT | $133.20 | $222 | $283.94 | 0.5× |
| Hilton Head Medical Center | Hilton Head Island, SC | $211.46 | — | $220.29 | 1.0× |
| East Cooper Medical Center | Mount Pleasant, SC | $211.46 | — | $220.29 | 1.0× |
| Coastal Carolina Medical Center | Hardeeville, SC | $211.46 | — | $220.29 | 1.0× |
| Lakeside Medical Center | Belle Glade, FL | $233.10 | — | $247.34 | 0.9× |
| Vanderbilt Bedford Hospital | Shelbyville, TN | $239.54 | $826 | $226.17 | 1.1× |
| Vanderbilt Tullahoma-Harton Hospital | Tullahoma, TN | $239.54 | $826 | $224.85 | 1.1× |
| Vanderbilt Wilson County Hospital | Lebanon, TN | $239.54 | $826 | $227.23 | 1.1× |
| Our Lady of the Lake Surgical Hospital | Slidell, LA | $254.99 | — | $215.09 | 1.2× |
| Nebraska Medical Center | Omaha, NE | $256.10 | $394 | $245.94 | 1.0× |
| Bellevue Medical Center | Bellevue, NE | $256.10 | $394 | $245.94 | 1.0× |
| Griffin Hospital | Derby, CT | $277.61 | — | $283.94 | 1.0× |
| Valleywise Health Medical Center | Phoenix, AZ | $290.65 | — | $252.74 | 1.1× |
| Saint Thomas Hospital for Specialty Surgery | Nashville, TN | $296.14 | — | $227.23 | 1.3× |
| Summit Surgical, LLC | Hutchinson, KS | $301.44 | $376.80 | $217.82 | 1.4× |
| Boca Raton Regional Hospital | Boca Raton, FL | $325.65 | $501 | $247.34 | 1.3× |
| Vanderbilt University Hospital | Nashville, TN | $446.04 | $826 | $232.50 | 1.9× |
| Duncan Regional Hospital, Inc | Duncan, OK | $473.44 | — | $227.80 | 2.1× |
| Northwest Surgical Hospital | Oklahoma City, OK | $683.40 | — | $227.80 | 3.0× |
| Community Hospital, LLC | Oklahoma City, OK | $683.40 | — | $227.80 | 3.0× |
| Baylor Scott & White Medical Center -taylor | Taylor, TX | $823.42 | $1,372.38 | $237.93 | 3.5× |
| Scott & White Hospital-round Rock | Round Rock, TX | $823.42 | $1,372.38 | $237.93 | 3.5× |
| Baylor Scott & White Medical Center - Pflugerville | Pflugerville, TX | $823.42 | $1,372.38 | $237.93 | 3.5× |
| Baylor Scott & White Medical Center - Buda | Buda, TX | $823.42 | $1,372.38 | $237.93 | 3.5× |
| Baylor Scott & White Medical Center- Austin | Austin, TX | $823.42 | $1,372.38 | $237.93 | 3.5× |
| Arkansas Children's Hospital | Little Rock, AR | $905.52 | $1,006.13 | $222.54 | 4.1× |
| Arkansas Children's Northwest | Springdale, AR | $905.52 | $1,006.13 | $221.06 | 4.1× |
| Baylor Scott & White Medical Center - Temple | Temple, TX | $907.27 | $1,512.12 | $237.93 | 3.8× |
| Baylor Scott & White Medical Center - Hillcrest | Waco, TX | $907.27 | $1,512.12 | $237.93 | 3.8× |
| Baylor Scott & White Medical Center- College Stati | College Station, TX | $907.27 | $1,512.12 | $237.93 | 3.8× |
| Baylor Scott & White Medical Center - Marble Falls | Marble Falls, TX | $907.27 | $1,512.12 | $237.93 | 3.8× |
| Baylor Scott & White Hospital Brenham | Brenham, TX | $907.27 | $1,512.12 | $237.93 | 3.8× |
| Baylor University Medical Center (Baylor Scott & White) | Dallas, TX | $1,607.44 | $2,679.06 | $237.93 | 6.8× |
| Baylor Scott and White Medical Center Irving | Irving, TX | $1,607.44 | $2,679.06 | $237.93 | 6.8× |
| Baylor Scott and White All Saints Medical Center | Fort Worth, TX | $1,607.44 | $2,679.06 | $237.93 | 6.8× |
| Baylor Scott & White Medical Center- Waxahachie | Waxahachie, TX | $1,607.44 | $2,679.06 | $237.93 | 6.8× |
| Baylor Scott & White Medical Center Grapevine | Grapevine, TX | $1,607.44 | $2,679.06 | $238.32 | 6.7× |
| Baylor Scott and White Medical Center Lake Pointe | Rowlett, TX | $1,607.44 | $2,679.06 | $237.93 | 6.8× |
| Baylor Scott & White Heart and Vascular Hospital | Dallas, TX | $1,607.44 | $2,679.06 | $237.93 | 6.8× |
| Baylor Scott & White Medical Center - Centennial | Frisco, TX | $1,607.44 | $2,679.06 | $237.93 | 6.8× |
| Baylor Regional Medical Center at Plano | Plano, TX | $1,607.44 | $2,679.06 | $237.93 | 6.8× |
| The Heart Hospital Baylor Denton | Denton, TX | $1,607.44 | $2,679.06 | $237.93 | 6.8× |
| Baylor Scott & White The Heart Hospital Plano | Plano, TX | $1,607.44 | $2,679.06 | $237.93 | 6.8× |
| Baylor Scott and White Medical Center Mckinney | Mc Kinney, TX | $1,607.44 | $2,679.06 | $237.93 | 6.8× |
| Baylor Scott and White Medical Center Frisco at Pg | Frisco, TX | $1,607.44 | $2,679.06 | $237.93 | 6.8× |
| Baylor Scott and White The Heart Hospital Corinth | Denton, TX | $1,607.44 | $2,679.06 | $237.93 | 6.8× |
| MUSC Health University Medical Center | Charleston, SC | $4,199 | $8,398 | $220.29 | 19.1× |
| Omega Hospital | Metairie, LA | $12,139.55 | $20,810.66 | $222.32 | 54.6× |
| Parkland Memorial Hospital | Dallas, TX | $15,125.95 | $37,814.88 | $237.93 | 63.6× |
| University of Texas M D Anderson Cancer Center | Houston, TX | — | $1,241 | $237.93 | — |
"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.