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Custom Additional Dental Procedure

Pennsylvania 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 rates vary

Facilitymedian $8,511 · 10th to 90th $5,012 to $77,625Professionalmedian $64,565 · 10th to 90th $64,565 to $64,565
$500$1K$2K$5K$10K$20K$50Kfacility $8,511professional $64,565

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
Aetna
Setting
Professional
Modifier
Global
Typical Low
$398.11
Median
$398.11
Typical High
$741.31
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$5,011.87
Median
$8,511.38
Typical High
$77,624.71
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$64,565.42
Median
$64,565.42
Typical High
$64,565.42