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Custom Tooth Restoration Procedure

Washington rates for HCPCS D2999

A tooth-repair treatment that doesn't match one of the standard, commonly used restoration procedures, so your dentist describes exactly what was done in detail. It's used for less typical situations where a tooth needs a customized approach to repair or rebuild it.

Rates data updated July 2026.

How much does Custom Tooth Restoration Procedure cost?

$4,677

Typical facility fee. In Washington, July 2026.

Insurers have agreed to pay about $4,677 for this service. Most negotiated rates run $1,413 to $7,762.

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 3 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $4,677 · 10th to 90th $1,413 to $7,943Professionalmedian $50 · 10th to 90th $32 to $79
$50$200$1K$5Kfacility $4,677professional $50

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
Kaiser Permanente
Setting
Facility
Modifier
Global
Typical Low
$1,412.54
Median
$4,677.35
Typical High
$7,943.28
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$50.12
Typical High
$79.43
Pacific Source
Setting
Facility
Modifier
Global
Typical Low
$831.76
Median
$831.76
Typical High
$831.76

Where Washington sits

The same service costs 4466835.9 times more in Florida than in Connecticut. 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.

Washington· 6th of 37

$4,677

FL $89,125CT $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.