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Custom Additional Dental Procedure

Texas 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$1050%50%100%90th$100Professionalmedian $30 · 10th–90th $30$5370%50%90th$30$50.0$200.0$1.0K$5.0K$20.0K$100.0K

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
Aetna
Setting
Professional
Modifier
Global
Typical Low
$537.03
Median
$537.03
Typical High
$537.03
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$104.71
Molina
Setting
Professional
Modifier
Global
Typical Low
$30.20
Median
$30.20
Typical High
$50.12
Providence
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$60.26
Typical High
$79.43
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$758.58
Median
$758.58
Typical High
$100,000.00