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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 July 2026.

Facilitymedian $100 · 10th–90th $100$1000%50%100%$100Professionalmedian $112 · 10th–90th $105$1120%50%10th$112$100.0

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
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$112.20
Typical High
$112.20
Medica
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Medica
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$104.71
Typical High
$104.71