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Custom Additional Dental Procedure

Massachusetts 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 July 2026.

Facilitymedian $4,898 · 10th–90th $83$9,7720%10%10th90th$4,898Professionalmedian $191 · 10th–90th $115$3020%20%10th90th$191$100.0$500.0$2.0K$10.0K$50.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample; interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
AllWays Health Partners
Setting
Facility
Modifier
Global
Typical Low
$104.71
Median
$104.71
Typical High
$104.71
Fallon Health
Setting
Facility
Modifier
Global
Typical Low
$83.18
Median
$5,888.44
Typical High
$9,772.37
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$190.55
Typical High
$302.00
Mass General Brigham
Setting
Facility
Modifier
Global
Typical Low
$104.71
Median
$104.71
Typical High
$104.71