A diagnostic service, used to evaluate your teeth, gums, or overall oral health, that doesn't match one of the standard, commonly used diagnostic procedures, so your dentist provides a detailed explanation of exactly what was done. It's used for less typical evaluations that need an individualized approach.
Rates data updated July 2026.
How much does Custom Diagnostic Procedure cost?
$11.75
Typical negotiated rate. Nationwide, July 2026.
Insurers have agreed to pay about $11.75 for this service. The price depends on where it is billed: about $11.75 from a physician practice, and about $891 from a hospital or other facility. The two figures are alternatives, not parts of one bill.
These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 17 insurance carriers under federal price transparency rules.
Where it's billed changes the price
Billed by
Who charges it
Typical
Range
Physician practiceA doctor's office, clinic or independent provider
A doctor's office, clinic or independent provider
$11.75
$10.00 to $74.13
FacilityA hospital or hospital-owned outpatient department
A hospital or hospital-owned outpatient department
$891
$302 to $1,622
How much rates vary
Facilitymedian $891 · 10th to 90th $1 to $1,622Professionalmedian $12 · 10th to 90th $1 to $117
Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
Insurance Carrier
Facility/Professional
Modifier
Typical LowTypical Low is the 10th percentile of the published rates, Median the 50th, and Typical High the 90th. One in ten rates falls below Typical Low, and one in ten falls above Typical High.
MedianTypical Low is the 10th percentile of the published rates, Median the 50th, and Typical High the 90th. One in ten rates falls below Typical Low, and one in ten falls above Typical High.
Typical HighTypical Low is the 10th percentile of the published rates, Median the 50th, and Typical High the 90th. One in ten rates falls below Typical Low, and one in ten falls above Typical High.
BCBS
Setting
Professional
Modifier
Global
Typical Low
$0.02
Median
$74.13
Typical High
$131.83
Professional
Global
$0.02
$74.13
$131.83
United
Setting
Professional
Modifier
Global
Typical Low
$5.01
Median
$5.01
Typical High
$5.01
Professional
Global
$5.01
$5.01
$5.01
What it costs in each state
The same service costs 3235936.6 times more in Pennsylvania than in Ohio. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Touch or drag across the chart to see any state's rate.
PA $64,565OH $0.02
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.
See more rates by state
Want provider-level rates data or 24+ months of history? We offer custom data extracts for a reasonable fee. To learn more, please email us.