Decor or submerg erupt tooth (CPT D3921)
D3921 is the billing code hospitals use for this service. Prices below are each hospital's own posted facility charge.
38 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 | — | $583.69 | 0.1× |
| Cincinnati Children's Hospital Medical Center | Cincinnati, OH | $268.01 | $525.50 | $630.01 | 0.4× |
| Westchester Medical Center | Valhalla, NY | $524 | $524 | $807 | 0.6× |
| Cedar-sinai Marina Del Rey Hospital range across 5 matching MRF lines |
Marina Del Rey, CA | $655.63–$18,447.52 | $1,008.66–$28,380.80 | $831.49 | varies |
| Highland Hospital | Rochester, NY | $767.37 | — | $807 | 1.0× |
| Strong Memorial Hospital | Rochester, NY | $767.37 | — | $807 | 1.0× |
| Valleywise Health Medical Center | Phoenix, AZ | $793.33 | — | $689.86 | 1.1× |
| Nyack Hospital | Nyack, NY | $807 | — | $807 | 1.0× |
| Montefiore St. Luke's Cornwall | Newburgh, NY | $807 | — | $807 | 1.0× |
| Henry Ford Macomb Hospital | Clinton Township, MI | $888.94 | — | $644.16 | 1.4× |
| Henry Ford Hospital | Detroit, MI | $888.94 | — | $644.16 | 1.4× |
| Henry Ford Wyandotte Hospital | Wyandotte, MI | $888.94 | — | $644.16 | 1.4× |
| Henry Ford West Bloomfield Hospital | West Bloomfield, MI | $888.94 | — | $644.16 | 1.4× |
| Dunes Surgical Hospital | Dakota Dunes, SD | $1,347.69 | — | $660.49 | 2.0× |
| Lakeside Medical Center | Belle Glade, FL | $1,668.91 | — | $675.11 | 2.5× |
| Huntington Hospital range across 4 matching MRF lines |
Pasadena, CA | $1,730.27–$15,116.08 | $2,661.95–$23,255.50 | $831.49 | varies |
| Our Lady of the Lake Surgical Hospital | Slidell, LA | $1,825.64 | — | $587.10 | 3.1× |
| Northwest Surgical Hospital | Oklahoma City, OK | $1,865.31 | — | $621.77 | 3.0× |
| Community Hospital, LLC | Oklahoma City, OK | $1,865.31 | — | $621.77 | 3.0× |
| Lincoln Medical & Mental Health Center | Bronx, NY | $1,967.49 | $60 | $807 | 2.4× |
| Jacobi Medical Center | Bronx, NY | $1,967.49 | $60 | $807 | 2.4× |
| Elmhurst Hospital Center | Elmhurst, NY | $1,967.49 | $60 | $807 | 2.4× |
| NYC Health + Hospitals/South Brooklyn Health | Brooklyn, NY | $1,967.49 | $60 | $807 | 2.4× |
| Metropolitan Hospital Center | New York, NY | $1,967.49 | $60 | $807 | 2.4× |
| Kings County Hospital Center | Brooklyn, NY | $1,967.49 | $60 | $807 | 2.4× |
| Bellevue Hospital Center | New York, NY | $1,967.49 | $60 | $807 | 2.4× |
| Queens Hospital Center | Jamaica, NY | $1,967.49 | $60 | $807 | 2.4× |
| Harlem Hospital Center | New York, NY | $1,967.49 | $60 | $807 | 2.4× |
| Woodhull Medical & Mental Health Center | Brooklyn, NY | $1,967.49 | $60 | $807 | 2.4× |
| Griffin Hospital | Derby, CT | $1,987.64 | — | $775.02 | 2.6× |
| Duncan Regional Hospital, Inc | Duncan, OK | $3,389.76 | — | $621.77 | 5.5× |
| Cedars-sinai Medical Center range across 4 matching MRF lines |
Los Angeles, CA | $3,964.84–$24,184.55 | $6,099.75–$37,207 | $831.49 | varies |
| St. Francis Hospital, Roslyn | Roslyn, NY | — | $750 | $807 | — |
| St. Charles Hospital | Port Jefferson, NY | — | $750 | $807 | — |
| Mercy Medical Center | Rockville Centre, NY | — | $750 | $807 | — |
| Good Samaritan Hospital Medical Center | West Islip, NY | — | $750 | $807 | — |
| St. Joseph Hospital | Bethpage, NY | — | $750 | $807 | — |
| St. Catherine of Siena Hospital | Smithtown, NY | — | $750 | $807 | — |
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.