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Dental Fee Comparison Tool

Compare an entered dental fee with distinctly labeled DHCS allowances, historical Medicaid payments, and available attributed market estimates.

Enter your numbers

Comparators measure different things. They are context for review, not a recommended fee or antitrust-safe-zone analysis.

Estimated result

Medi-Cal maximum

$340

Entered fee is $910 (267.6%) above this value.

Official maximum allowance effective 2026-09-01.

Source

Medicaid paid average

$474

Entered fee is $776 (163.9%) above this value.

2023-2024; 184,307 claim lines. Paid amount, not a fee schedule.

Source

California cost estimate

$2,331

Entered fee is $1,081 (46.4%) below this value.

Observed California consumer cost estimate for 2023-2024.

Source

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Using the estimate

What this tool can tell you

The comparison tool places an entered office fee beside available public measures. The measures are intentionally kept separate because a Medi-Cal maximum, historical Medicaid payment, consumer market estimate, and insurer-negotiated rate do not represent the same transaction.

Step-by-step guide

Keep unlike fee measures separate

Step 1

Start with the office fee

Enter the practice's current fee for the selected procedure. The tool calculates arithmetic differences only and does not upload or save the value.

Step 2

Identify each comparator

A DHCS maximum allowance, historical Medicaid paid amount, consumer market estimate, and commercial negotiated rate answer different questions. Use the source label and period beside each available figure.

Step 3

Investigate before changing a schedule

Review procedure volume, collections, write-offs, payer contracts, costs, and local service scope independently. A public comparator by itself does not determine an appropriate office fee.

Common questions

Questions about this tool

Does this tool recommend what a dentist should charge?
No. It performs comparisons against distinctly labeled public measures. It does not coordinate fees, recommend a percentile, or replace independent business and legal judgment.
Are Medicaid paid amounts the same as office fees?
No. A paid amount reflects historical Medicaid claim reporting. It is not the office's standard fee, a cash price, a commercial allowed amount, or the current Medi-Cal maximum.
Where are commercial negotiated-rate comparisons?
The data pipeline accepts bounded Transparency in Coverage files and removes provider identifiers after aggregation. A negotiated-rate comparator appears only after a real payer file passes source, date, and observation-count checks.