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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 October 2026.

How much rates vary

Facilitymedian $3,631 · 10th to 90th $83 to $9,772Professionalmedian $257 · 10th to 90th $135 to $324
$100$1K$10Kfacility $3,631professional $257

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
Fallon Health
Setting
Facility
Modifier
None
Typical Low
$83.18
Median
$3,630.78
Typical High
$9,772.37
Harvard Pilgrim
Setting
Professional
Modifier
None
Typical Low
$134.90
Median
$257.04
Typical High
$323.59