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Custom Additional Dental Procedure

Minnesota 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 $76 · 10th to 90th $76 to $105Professionalmedian $68 · 10th to 90th $60 to $76
$100facility $76professional $68

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
BCBS Minnesota
Setting
Facility
Modifier
None
Typical Low
$75.86
Median
$75.86
Typical High
$75.86
BCBS Minnesota
Setting
Professional
Modifier
None
Typical Low
$60.26
Median
$67.61
Typical High
$75.86
Medica
Setting
Facility
Modifier
None
Typical Low
$104.71
Median
$104.71
Typical High
$104.71