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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.

How much does Custom Additional Dental Procedure cost?

$200

Typical facility fee. In Massachusetts, July 2026.

Insurers have agreed to pay about $200 for this service. Most negotiated rates run $135 to $269.

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 4 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $4,898 · 10th to 90th $83 to $9,772Professionalmedian $191 · 10th to 90th $115 to $302
$100$1K$10Kfacility $4,898professional $191

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
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

Where Massachusetts sits

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.

Massachusetts· 9th of 40

$200

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.