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Custom Additional Dental Procedure

Missouri 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 $105 · 10th to 90th $100 to $105Professionalmedian $112 · 10th to 90th $112 to $112
$100facility $105professional $112

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
Professional
Modifier
None
Typical Low
$112.20
Median
$112.20
Typical High
$112.20
Medica
Setting
Facility
Modifier
None
Typical Low
$100.00
Median
$104.71
Typical High
$104.71
Medica
Setting
Professional
Modifier
None
Typical Low
$104.71
Median
$104.71
Typical High
$104.71