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Custom Additional Dental Procedure

Indiana rates for HCPCS D9999

A dental service that supports or adds to your main treatment but doesn't match one of the standard, commonly used procedures, so your dentist provides a detailed explanation of exactly what was done. It covers a wide range of miscellaneous services that don't fit neatly elsewhere.

Rates data updated October 2026.

How much rates vary

Facilitymedian $912 · 10th to 90th $1 to $2,188Professionalmedian $1 · 10th to 90th $1 to $1
$1$10$100$1Kfacility $912professional $1

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Anthem BCBS
Setting
Facility
Modifier
None
Typical Low
$1.00
Median
$1.00
Typical High
$1.95
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$1.00
Median
$1.00
Typical High
$1.41
Physicians Health Plan of Northern Indiana
Setting
Facility
Modifier
None
Typical Low
$912.01
Median
$2,089.30
Typical High
$2,290.87