{ "meta": { "api_version": "v1", "edition": "2026.1", "generated_at": "2026-09-02T08:23:06.575Z", "license": "CC-BY-4.0", "license_url": "https://creativecommons.org/licenses/by/4.0/", "attribution_required": true, "attribution": "Real Dental Costs — https://realdentalcosts.com", "doi": "https://doi.org/10.5281/zenodo.20531728", "methodology": "https://realdentalcosts.com/en/methodology/", "docs": "https://realdentalcosts.com/en/api/", "disclaimer": "Independent pricing and market research. NOT medical, dental or insurance advice.", "source": "HHS/CMS Medicaid Provider Spending by HCPCS (T-MSIS), version 2026-02-09 (federal government work; attribution by courtesy)", "source_url": "https://opendata.hhs.gov/datasets/medicaid-provider-spending/", "dataset_doi": "https://doi.org/10.7910/DVN/7F2BZI", "dataset": "Medicaid dental paid per claim line by CDT code and state, 2018-2024", "geolocation": "Provider NPI (servicing, else billing) joined to NPPES August 2026 practice address; 99.4% of dental lines matched", "suppression": "HHS publishes a provider x code x month cell only if >= 12 claim lines AND >= 12 patients", "measure": "paid_per_line_wavg = sum(paid)/sum(claim lines); median_cell/p25/p75 = distribution of paid/lines across published cells", "period_note": "2024 preliminary; CHIP included; FFS + managed-care encounters; outpatient/professional only", "generated": "2026-08-22", "generated_by": "scripts/gen_medicaid_paid.py (DuckDB, outside the build)", "license_derived": "CC BY 4.0 (Real Dental Costs derived tables)", "labels_note": "Procedure labels are Real Dental Costs' own wording; CDT descriptors are copyright ADA and are not reproduced." }, "code": "D3330", "label": "molar root canal", "label_note": "Procedure label written by Real Dental Costs; CDT code cited by number only (CDT descriptors are © American Dental Association).", "price_type": "medicaid_paid", "measure": "Medicaid paid amount per claim line (sum of paid / sum of claim lines), USD. Paid ≠ allowed ≠ charge; not a consumer price.", "provenance": { "price_type": "medicaid_paid", "basis": "observed", "source_id": "hhs_tmsis_medicaid_provider_spending_2026_02_09", "source": "HHS/CMS Medicaid Provider Spending by HCPCS (T-MSIS), v2026-02-09; provider NPI → state via NPPES (Aug 2026)", "source_url": "https://opendata.hhs.gov/datasets/medicaid-provider-spending/", "observation_type": "Medicaid paid per claim line, code D3330 (FFS + managed-care encounters + CHIP; cells suppressed below 12 lines / 12 patients)", "period": "2023-2024", "period_end": "2024-12", "sample_n": 347421, "geo_level": "national", "updated": "2026-08-23", "modeled": false, "confidence": 74, "confidence_note": "Paid amount per claim line, not an allowed amount or a consumer price; managed-care states may report nominal amounts; 2024 is preliminary." }, "national": { "period": "2023-2024", "paid_per_line_wavg": 516.24, "median_cell": 463.4, "p25": 452.82, "p75": 666.25, "lines": 347421, "patients": 307161, "n_providers": 1626, "n_cells": 13351, "by_year": { "2018": { "paid_per_line_wavg": 443.37, "median_cell": 462.28, "p25": 375.73, "p75": 500, "lines": 57883, "patients": 48983, "n_providers": 517, "n_cells": 2285 }, "2019": { "paid_per_line_wavg": 465.01, "median_cell": 463.4, "p25": 385.4, "p75": 533.63, "lines": 65959, "patients": 57229, "n_providers": 550, "n_cells": 2664 }, "2020": { "paid_per_line_wavg": 461.18, "median_cell": 463.4, "p25": 379.02, "p75": 525, "lines": 58516, "patients": 51077, "n_providers": 548, "n_cells": 2484 }, "2021": { "paid_per_line_wavg": 467.49, "median_cell": 463.4, "p25": 390.76, "p75": 546.77, "lines": 96596, "patients": 86028, "n_providers": 786, "n_cells": 4018 }, "2022": { "paid_per_line_wavg": 496.99, "median_cell": 463.4, "p25": 420.67, "p75": 625.04, "lines": 125691, "patients": 110494, "n_providers": 885, "n_cells": 4781 }, "2023": { "paid_per_line_wavg": 514.11, "median_cell": 463.4, "p25": 447.76, "p75": 650.7, "lines": 174897, "patients": 154847, "n_providers": 1176, "n_cells": 6558 }, "2024": { "paid_per_line_wavg": 518.4, "median_cell": 463.4, "p25": 457.3, "p75": 680.04, "lines": 172524, "patients": 152314, "n_providers": 1267, "n_cells": 6793 } } }, "cash_benchmark": { "procedure_id": "rootcanal", "procedure_slug": "root-canal", "label": "Root canal", "national_low_usd": 500, "national_avg_usd": 1100, "national_high_usd": 1500, "basis": "estimated", "url": "https://realdentalcosts.com/api/v1/procedure/root-canal.json", "ratio_cash_avg_to_medicaid_paid": 2.1 }, "states": [ { "state": "Alaska", "code": "AK", "quality_flag": "ok", "quality_evidence": null, "latest": { "period": "2023-2024", "paid_per_line_wavg": 594.87, "median_cell": 640.8, "p25": 511.19, "p75": 698.3, "lines": 233, "patients": 203, "n_providers": 2, "n_cells": 14 }, "confidence": 79, "official_fee": null, "by_year": { "2018": { "paid_per_line_wavg": 574.66, "median_cell": 595.8, "p25": 517.51, "p75": 632.79, "lines": 265, "patients": 224, "n_providers": 2, "n_cells": 13 }, "2019": { "paid_per_line_wavg": 579.34, "median_cell": 576.15, "p25": 551.82, "p75": 620.45, "lines": 182, "patients": 158, "n_providers": 2, "n_cells": 8 }, "2020": { "paid_per_line_wavg": 497.05, "median_cell": 515.94, "p25": 455.56, "p75": 583.34, "lines": 243, "patients": 185, "n_providers": 2, "n_cells": 12 }, "2021": { "paid_per_line_wavg": 551.48, "median_cell": 533.92, "p25": 521.46, "p75": 581.36, "lines": 253, "patients": 213, "n_providers": 1, "n_cells": 11 }, "2022": { "paid_per_line_wavg": 531.99, "median_cell": 556.98, "p25": 511, "p75": 575.21, "lines": 186, "patients": 142, "n_providers": 1, "n_cells": 8 }, "2023": { "paid_per_line_wavg": 569.18, "median_cell": 602.54, "p25": 505.14, "p75": 658.64, "lines": 140, "patients": 118, "n_providers": 2, "n_cells": 8 }, "2024": { "paid_per_line_wavg": 633.54, "median_cell": 693.12, "p25": 560.61, "p75": 711.41, "lines": 93, "patients": 85, "n_providers": 1, "n_cells": 6 } } }, { "state": "Alabama", "code": "AL", "quality_flag": "ok", "quality_evidence": null, "latest": { "period": "2023-2024", "paid_per_line_wavg": 463.72, "median_cell": 533.04, "p25": 422.31, "p75": 610.64, "lines": 3376, "patients": 2570, "n_providers": 17, "n_cells": 138 }, "confidence": 82, "official_fee": null, "by_year": { "2018": { "paid_per_line_wavg": 382.21, "median_cell": 470.57, "p25": 387, "p75": 484.36, "lines": 407, "patients": 337, "n_providers": 9, "n_cells": 20 }, "2019": { "paid_per_line_wavg": 459.66, "median_cell": 471.13, "p25": 437.69, "p75": 494.88, "lines": 498, "patients": 448, "n_providers": 6, "n_cells": 26 }, "2020": { "paid_per_line_wavg": 477.03, "median_cell": 493.06, "p25": 464.51, "p75": 516, "lines": 356, "patients": 333, "n_providers": 4, "n_cells": 18 }, "2021": { "paid_per_line_wavg": 506.67, "median_cell": 527.06, "p25": 499.8, "p75": 567.6, "lines": 715, "patients": 641, "n_providers": 9, "n_cells": 38 }, "2022": { "paid_per_line_wavg": 493.36, "median_cell": 518.88, "p25": 469.51, "p75": 567.6, "lines": 1144, "patients": 1014, "n_providers": 10, "n_cells": 54 }, "2023": { "paid_per_line_wavg": 484.45, "median_cell": 521.05, "p25": 428.75, "p75": 567.6, "lines": 1570, "patients": 1256, "n_providers": 15, "n_cells": 67 }, "2024": { "paid_per_line_wavg": 445.69, "median_cell": 555.79, "p25": 391.88, "p75": 638.67, "lines": 1806, "patients": 1314, "n_providers": 11, "n_cells": 71 } } }, { "state": "Arkansas", "code": "AR", "quality_flag": "ok", "quality_evidence": null, "latest": { "period": "2023-2024", "paid_per_line_wavg": 519.17, "median_cell": 552.57, "p25": 479.84, "p75": 562.79, "lines": 244, "patients": 215, "n_providers": 3, "n_cells": 15 }, "confidence": 81, "official_fee": null, "by_year": { "2018": { "paid_per_line_wavg": 568.63, "median_cell": 567.34, "p25": 565, "p75": 569.67, "lines": 36, "patients": 33, "n_providers": 1, "n_cells": 2 }, "2020": { "paid_per_line_wavg": 559.49, "median_cell": 559.49, "p25": 559.49, "p75": 559.49, "lines": 15, "patients": 14, "n_providers": 1, "n_cells": 1 }, "2022": { "paid_per_line_wavg": 498.17, "median_cell": 499.15, "p25": 491.81, "p75": 506.48, "lines": 30, "patients": 30, "n_providers": 1, "n_cells": 2 }, "2023": { "paid_per_line_wavg": 543.16, "median_cell": 563.6, "p25": 501.69, "p75": 599.45, "lines": 76, "patients": 71, "n_providers": 2, "n_cells": 5 }, "2024": { "paid_per_line_wavg": 508.32, "median_cell": 522.49, "p25": 476.54, "p75": 558.59, "lines": 168, "patients": 144, "n_providers": 3, "n_cells": 10 } } }, { "state": "Arizona", "code": "AZ", "quality_flag": "nominal_amounts_suspected", "quality_evidence": "Managed-care encounters likely carry nominal paid amounts: D0120 median 7$ vs US 26$; D1110 median 14$ vs US 47$; D2392 median 33$ vs US 79$", "latest": { "period": "2023-2024", "paid_per_line_wavg": 212.9, "median_cell": 159.29, "p25": 68.27, "p75": 276.55, "lines": 4138, "patients": 3761, "n_providers": 26, "n_cells": 205 }, "confidence": 76, "official_fee": null, "by_year": { "2018": { "paid_per_line_wavg": 173.18, "median_cell": 139.75, "p25": 59.35, "p75": 244.8, "lines": 987, "patients": 815, "n_providers": 13, "n_cells": 36 }, "2019": { "paid_per_line_wavg": 305.74, "median_cell": 265.14, "p25": 96.76, "p75": 379.02, "lines": 1686, "patients": 1492, "n_providers": 15, "n_cells": 55 }, "2020": { "paid_per_line_wavg": 294.45, "median_cell": 273.55, "p25": 124.51, "p75": 361.05, "lines": 2236, "patients": 2016, "n_providers": 23, "n_cells": 95 }, "2021": { "paid_per_line_wavg": 209.42, "median_cell": 187.88, "p25": 87.04, "p75": 319.35, "lines": 2920, "patients": 2613, "n_providers": 22, "n_cells": 129 }, "2022": { "paid_per_line_wavg": 183.91, "median_cell": 201.08, "p25": 101.43, "p75": 283.59, "lines": 2362, "patients": 2126, "n_providers": 19, "n_cells": 105 }, "2023": { "paid_per_line_wavg": 196.48, "median_cell": 129.82, "p25": 46.87, "p75": 262.59, "lines": 2277, "patients": 2082, "n_providers": 19, "n_cells": 110 }, "2024": { "paid_per_line_wavg": 232.98, "median_cell": 181.09, "p25": 81.83, "p75": 297.57, "lines": 1861, "patients": 1679, "n_providers": 19, "n_cells": 95 } } }, { "state": "California", "code": "CA", "quality_flag": "ok", "quality_evidence": null, "latest": { "period": "2023-2024", "paid_per_line_wavg": 492.64, "median_cell": 463.4, "p25": 463.4, "p75": 463.4, "lines": 114367, "patients": 103891, "n_providers": 519, "n_cells": 4532 }, "confidence": 86, "official_fee": null, "by_year": { "2018": { "paid_per_line_wavg": 464.52, "median_cell": 463.4, "p25": 455.68, "p75": 463.4, "lines": 16975, "patients": 15077, "n_providers": 152, "n_cells": 678 }, "2019": { "paid_per_line_wavg": 475.51, "median_cell": 463.4, "p25": 463.4, "p75": 463.4, "lines": 22992, "patients": 20309, "n_providers": 185, "n_cells": 875 }, "2020": { "paid_per_line_wavg": 493.7, "median_cell": 463.4, "p25": 463.4, "p75": 463.4, "lines": 19453, "patients": 17214, "n_providers": 171, "n_cells": 804 }, "2021": { "paid_per_line_wavg": 479.36, "median_cell": 463.4, "p25": 463.4, "p75": 463.4, "lines": 30080, "patients": 27055, "n_providers": 239, "n_cells": 1218 }, "2022": { "paid_per_line_wavg": 486.3, "median_cell": 463.4, "p25": 463.4, "p75": 463.4, "lines": 36661, "patients": 32838, "n_providers": 272, "n_cells": 1419 }, "2023": { "paid_per_line_wavg": 491.91, "median_cell": 463.4, "p25": 463.4, "p75": 463.4, "lines": 55480, "patients": 50686, "n_providers": 374, "n_cells": 2219 }, "2024": { "paid_per_line_wavg": 493.32, "median_cell": 463.4, "p25": 463.4, "p75": 463.4, "lines": 58887, "patients": 53205, "n_providers": 423, "n_cells": 2313 } } }, { "state": "Colorado", "code": "CO", "quality_flag": "ok", "quality_evidence": null, "latest": { "period": "2023-2024", "paid_per_line_wavg": 592.83, "median_cell": 486.76, "p25": 465.1, "p75": 1086.18, "lines": 1936, "patients": 1823, "n_providers": 28, "n_cells": 114 }, "confidence": 76, "official_fee": null, "by_year": { "2018": { "paid_per_line_wavg": 452.02, "median_cell": 448.8, "p25": 439.34, "p75": 453.34, "lines": 717, "patients": 694, "n_providers": 6, "n_cells": 42 }, "2019": { "paid_per_line_wavg": 452.11, "median_cell": 453.15, "p25": 445.35, "p75": 456.58, "lines": 534, "patients": 460, "n_providers": 5, "n_cells": 29 }, "2020": { "paid_per_line_wavg": 456.05, "median_cell": 452.01, "p25": 444.95, "p75": 470.15, "lines": 430, "patients": 409, "n_providers": 6, "n_cells": 28 }, "2021": { "paid_per_line_wavg": 450.75, "median_cell": 460.47, "p25": 446.85, "p75": 463.31, "lines": 279, "patients": 270, "n_providers": 7, "n_cells": 19 }, "2022": { "paid_per_line_wavg": 467.03, "median_cell": 463.66, "p25": 455.52, "p75": 472.58, "lines": 412, "patients": 398, "n_providers": 8, "n_cells": 26 }, "2023": { "paid_per_line_wavg": 438.7, "median_cell": 482.4, "p25": 463.01, "p75": 486.76, "lines": 676, "patients": 633, "n_providers": 15, "n_cells": 41 }, "2024": { "paid_per_line_wavg": 675.52, "median_cell": 486.76, "p25": 470.91, "p75": 1109.31, "lines": 1260, "patients": 1190, "n_providers": 20, "n_cells": 73 } } }, { "state": "Connecticut", "code": "CT", "quality_flag": "ok", "quality_evidence": null, "latest": { "period": "2023-2024", "paid_per_line_wavg": 580.04, "median_cell": 706.18, "p25": 536.37, "p75": 775.83, "lines": 5709, "patients": 4122, "n_providers": 35, "n_cells": 223 }, "confidence": 82, "official_fee": null, "by_year": { "2018": { "paid_per_line_wavg": 394.28, "median_cell": 406.18, "p25": 344.61, "p75": 456.33, "lines": 1731, "patients": 1165, "n_providers": 9, "n_cells": 59 }, "2019": { "paid_per_line_wavg": 428.84, "median_cell": 440.72, "p25": 352.5, "p75": 512.36, "lines": 1550, "patients": 1150, "n_providers": 11, "n_cells": 62 }, "2020": { "paid_per_line_wavg": 397.38, "median_cell": 399.17, "p25": 289.27, "p75": 454.18, "lines": 1022, "patients": 727, "n_providers": 14, "n_cells": 46 }, "2021": { "paid_per_line_wavg": 433.98, "median_cell": 427.5, "p25": 317.92, "p75": 564.04, "lines": 2053, "patients": 1550, "n_providers": 22, "n_cells": 90 }, "2022": { "paid_per_line_wavg": 562.15, "median_cell": 643.28, "p25": 455, "p75": 769.12, "lines": 2020, "patients": 1547, "n_providers": 18, "n_cells": 89 }, "2023": { "paid_per_line_wavg": 611.22, "median_cell": 696.84, "p25": 575.77, "p75": 748.92, "lines": 2810, "patients": 2089, "n_providers": 27, "n_cells": 113 }, "2024": { "paid_per_line_wavg": 549.82, "median_cell": 719.66, "p25": 370.35, "p75": 802.38, "lines": 2899, "patients": 2033, "n_providers": 24, "n_cells": 110 } } }, { "state": "District of Columbia", "code": "DC", "quality_flag": "ok", "quality_evidence": null, "latest": { "period": "2023-2024", "paid_per_line_wavg": 586.65, "median_cell": 632.6, "p25": 591.02, "p75": 748, "lines": 4897, "patients": 4057, "n_providers": 11, "n_cells": 159 }, "confidence": 83, "official_fee": null, "by_year": { "2018": { "paid_per_line_wavg": 587.95, "median_cell": 591.12, "p25": 579.43, "p75": 605.4, "lines": 542, "patients": 452, "n_providers": 5, "n_cells": 23 }, "2019": { "paid_per_line_wavg": 595.92, "median_cell": 599.55, "p25": 589.3, "p75": 610.92, "lines": 768, "patients": 678, "n_providers": 4, "n_cells": 32 }, "2020": { "paid_per_line_wavg": 592.58, "median_cell": 598.68, "p25": 581.15, "p75": 606.23, "lines": 1052, "patients": 909, "n_providers": 3, "n_cells": 32 }, "2021": { "paid_per_line_wavg": 585.4, "median_cell": 605.9, "p25": 583.88, "p75": 618.89, "lines": 1488, "patients": 1289, "n_providers": 9, "n_cells": 51 }, "2022": { "paid_per_line_wavg": 654.55, "median_cell": 618.5, "p25": 600.25, "p75": 679, "lines": 1525, "patients": 1393, "n_providers": 7, "n_cells": 65 }, "2023": { "paid_per_line_wavg": 604.17, "median_cell": 638.55, "p25": 602.82, "p75": 748, "lines": 2639, "patients": 2185, "n_providers": 8, "n_cells": 81 }, "2024": { "paid_per_line_wavg": 566.18, "median_cell": 625.68, "p25": 582, "p75": 748, "lines": 2258, "patients": 1872, "n_providers": 11, "n_cells": 78 } } }, { "state": "Delaware", "code": "DE", "quality_flag": "ok", "quality_evidence": null, "latest": { "period": "2023-2024", "paid_per_line_wavg": 938.49, "median_cell": 965.8, "p25": 911.76, "p75": 1001.55, "lines": 647, "patients": 583, "n_providers": 3, "n_cells": 26 }, "confidence": 84, "official_fee": null, "by_year": { "2018": { "paid_per_line_wavg": 878.58, "median_cell": 878.58, "p25": 878.58, "p75": 878.58, "lines": 29, "patients": 27, "n_providers": 1, "n_cells": 2 }, "2019": { "paid_per_line_wavg": 822.5, "median_cell": 831.16, "p25": 776.99, "p75": 868.6, "lines": 94, "patients": 84, "n_providers": 2, "n_cells": 6 }, "2020": { "paid_per_line_wavg": 920.42, "median_cell": 923.5, "p25": 881.26, "p75": 957.7, "lines": 83, "patients": 77, "n_providers": 2, "n_cells": 6 }, "2021": { "paid_per_line_wavg": 918.95, "median_cell": 928.53, "p25": 891.85, "p75": 983.15, "lines": 207, "patients": 192, "n_providers": 4, "n_cells": 13 }, "2022": { "paid_per_line_wavg": 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3141, "n_providers": 19, "n_cells": 125 }, "2024": { "paid_per_line_wavg": 599.48, "median_cell": 576.61, "p25": 530.56, "p75": 611.18, "lines": 3437, "patients": 3035, "n_providers": 22, "n_cells": 124 } } }, { "state": "Utah", "code": "UT", "quality_flag": "ok", "quality_evidence": null, "latest": { "period": "2023-2024", "paid_per_line_wavg": 607.24, "median_cell": 639.5, "p25": 630.23, "p75": 655.83, "lines": 745, "patients": 678, "n_providers": 1, "n_cells": 23 }, "confidence": 85, "official_fee": null, "by_year": { "2018": { "paid_per_line_wavg": 187.74, "median_cell": 202.53, "p25": 147.38, "p75": 217.19, "lines": 377, "patients": 331, "n_providers": 2, "n_cells": 13 }, "2019": { "paid_per_line_wavg": 228.3, "median_cell": 200.24, "p25": 183.19, "p75": 255.78, "lines": 481, "patients": 423, "n_providers": 1, "n_cells": 11 }, "2020": { "paid_per_line_wavg": 216.94, "median_cell": 213.89, "p25": 161.77, "p75": 254.57, "lines": 528, "patients": 469, "n_providers": 1, "n_cells": 12 }, "2021": { "paid_per_line_wavg": 232.69, "median_cell": 225.89, "p25": 171.19, "p75": 269.25, "lines": 526, "patients": 454, "n_providers": 1, "n_cells": 12 }, "2022": { "paid_per_line_wavg": 225.75, "median_cell": 213.21, "p25": 192.99, "p75": 273.93, "lines": 507, "patients": 441, "n_providers": 1, "n_cells": 12 }, "2023": { "paid_per_line_wavg": 582.56, "median_cell": 638.06, "p25": 581.23, "p75": 647.86, "lines": 468, "patients": 424, "n_providers": 1, "n_cells": 12 }, "2024": { "paid_per_line_wavg": 648.92, "median_cell": 655.72, "p25": 634.31, "p75": 660.71, "lines": 277, "patients": 254, "n_providers": 1, "n_cells": 11 } } }, { "state": "Virginia", "code": "VA", "quality_flag": "nominal_amounts_suspected", "quality_evidence": "Managed-care encounters likely carry nominal paid amounts: D0120 median 0$ vs US 26$; D1110 median 0$ vs US 47$; D2392 median 0$ vs US 79$; D2740 median 0$ vs US 482$; D7140 median 0$ vs US 60$", "latest": { "period": "2023-2024", "paid_per_line_wavg": 231.47, "median_cell": 0, "p25": 0, "p75": 647.58, "lines": 12835, "patients": 11201, "n_providers": 63, "n_cells": 483 }, "confidence": 76, "official_fee": null, "by_year": { "2018": { "paid_per_line_wavg": 571.71, "median_cell": 674.78, "p25": 379.02, "p75": 679, "lines": 1118, "patients": 882, "n_providers": 9, "n_cells": 45 }, "2019": { "paid_per_line_wavg": 643.38, "median_cell": 674, "p25": 641.14, "p75": 679, "lines": 810, "patients": 725, "n_providers": 5, "n_cells": 29 }, "2020": { "paid_per_line_wavg": 642.86, "median_cell": 670.77, "p25": 610.06, "p75": 679, "lines": 850, "patients": 744, "n_providers": 6, "n_cells": 29 }, "2021": { "paid_per_line_wavg": 657.57, "median_cell": 679, "p25": 668.56, "p75": 679, "lines": 2360, "patients": 2072, "n_providers": 22, "n_cells": 90 }, "2022": { "paid_per_line_wavg": 761.78, "median_cell": 690.95, "p25": 679, "p75": 882.7, "lines": 5089, "patients": 4451, "n_providers": 40, "n_cells": 198 }, "2023": { "paid_per_line_wavg": 410.97, "median_cell": 379.02, "p25": 0, "p75": 879.31, "lines": 6698, "patients": 5762, "n_providers": 46, "n_cells": 246 }, "2024": { "paid_per_line_wavg": 35.57, "median_cell": 0, "p25": 0, "p75": 0, "lines": 6137, "patients": 5439, "n_providers": 50, "n_cells": 237 } } }, { "state": "Vermont", "code": "VT", "quality_flag": "ok", "quality_evidence": null, "latest": { "period": "2023-2024", "paid_per_line_wavg": 779.31, "median_cell": 779.31, "p25": 779.31, "p75": 779.31, "lines": 13, "patients": 12, "n_providers": 1, "n_cells": 1 }, "confidence": 66, "official_fee": null, "by_year": { "2024": { "paid_per_line_wavg": 779.31, "median_cell": 779.31, "p25": 779.31, "p75": 779.31, "lines": 13, "patients": 12, "n_providers": 1, "n_cells": 1 } } }, { "state": "Washington", "code": "WA", "quality_flag": "ok", "quality_evidence": null, "latest": { "period": "2023-2024", "paid_per_line_wavg": 451.17, "median_cell": 519.5, "p25": 454.46, "p75": 543.11, "lines": 6444, "patients": 5852, "n_providers": 17, "n_cells": 223 }, "confidence": 84, "official_fee": null, "by_year": { "2018": { "paid_per_line_wavg": 463.38, "median_cell": 517.84, "p25": 419.68, "p75": 543.11, "lines": 1264, "patients": 1083, "n_providers": 9, "n_cells": 64 }, "2019": { "paid_per_line_wavg": 458.39, "median_cell": 482.76, "p25": 424.26, "p75": 538.31, "lines": 1110, "patients": 969, "n_providers": 9, "n_cells": 51 }, "2020": { "paid_per_line_wavg": 445.67, "median_cell": 485.94, "p25": 413.25, "p75": 529.69, "lines": 1263, "patients": 1078, "n_providers": 10, "n_cells": 51 }, "2021": { "paid_per_line_wavg": 512.48, "median_cell": 514.53, "p25": 476.61, "p75": 543.11, "lines": 2499, "patients": 2171, "n_providers": 9, "n_cells": 82 }, "2022": { "paid_per_line_wavg": 552.95, "median_cell": 543.11, "p25": 501.63, "p75": 553.87, "lines": 2937, "patients": 2703, "n_providers": 10, "n_cells": 89 }, "2023": { "paid_per_line_wavg": 487.83, "median_cell": 524.49, "p25": 462.96, "p75": 544.03, "lines": 3316, "patients": 3009, "n_providers": 12, "n_cells": 108 }, "2024": { "paid_per_line_wavg": 412.31, "median_cell": 512.94, "p25": 418.05, "p75": 543.11, "lines": 3128, "patients": 2843, "n_providers": 15, "n_cells": 115 } } }, { "state": "Wisconsin", "code": "WI", "quality_flag": "ok", "quality_evidence": null, "latest": { "period": "2023-2024", "paid_per_line_wavg": 370.84, "median_cell": 373.28, "p25": 334.61, "p75": 404.69, "lines": 2230, "patients": 1875, "n_providers": 9, "n_cells": 91 }, "confidence": 84, "official_fee": null, "by_year": { "2018": { "paid_per_line_wavg": 236.67, "median_cell": 254.51, "p25": 161.91, "p75": 279.68, "lines": 596, "patients": 491, "n_providers": 3, "n_cells": 23 }, "2019": { "paid_per_line_wavg": 289.26, "median_cell": 298.25, "p25": 277.54, "p75": 310.59, "lines": 485, "patients": 455, "n_providers": 2, "n_cells": 20 }, "2020": { "paid_per_line_wavg": 277.25, "median_cell": 282.44, "p25": 268.47, "p75": 289.63, "lines": 391, "patients": 353, "n_providers": 2, "n_cells": 15 }, "2021": { "paid_per_line_wavg": 271.82, "median_cell": 271.14, "p25": 245.1, "p75": 296.41, "lines": 603, "patients": 543, "n_providers": 5, "n_cells": 26 }, "2022": { "paid_per_line_wavg": 342.48, "median_cell": 360.89, "p25": 323.21, "p75": 379.02, "lines": 991, "patients": 814, "n_providers": 4, "n_cells": 41 }, "2023": { "paid_per_line_wavg": 369.18, "median_cell": 372.78, "p25": 334.71, "p75": 399.06, "lines": 1017, "patients": 879, "n_providers": 8, "n_cells": 44 }, "2024": { "paid_per_line_wavg": 372.23, "median_cell": 373.28, "p25": 338.52, "p75": 412.81, "lines": 1213, "patients": 996, "n_providers": 6, "n_cells": 47 } } }, { "state": "West Virginia", "code": "WV", "quality_flag": "ok", "quality_evidence": null, "latest": { "period": "2023-2024", "paid_per_line_wavg": 607.52, "median_cell": 623.53, "p25": 582.85, "p75": 661.5, "lines": 1505, "patients": 1288, "n_providers": 8, "n_cells": 59 }, "confidence": 85, "official_fee": null, "by_year": { "2018": { "paid_per_line_wavg": 257.35, "median_cell": 250.16, "p25": 219.58, "p75": 280.74, "lines": 34, "patients": 28, "n_providers": 1, "n_cells": 2 }, "2019": { "paid_per_line_wavg": 298.48, "median_cell": 325.86, "p25": 231.52, "p75": 328.7, "lines": 112, "patients": 86, "n_providers": 1, "n_cells": 5 }, "2020": { "paid_per_line_wavg": 533.5, "median_cell": 489.72, "p25": 461.27, "p75": 594.98, "lines": 188, "patients": 107, "n_providers": 2, "n_cells": 7 }, "2021": { "paid_per_line_wavg": 390.38, "median_cell": 489.18, "p25": 367.24, "p75": 606.38, "lines": 424, "patients": 310, "n_providers": 4, "n_cells": 21 }, "2022": { "paid_per_line_wavg": 353.03, "median_cell": 470.41, "p25": 177.84, "p75": 625.58, "lines": 744, "patients": 488, "n_providers": 7, "n_cells": 30 }, "2023": { "paid_per_line_wavg": 596.57, "median_cell": 614.64, "p25": 582.12, "p75": 660, "lines": 780, "patients": 673, "n_providers": 8, "n_cells": 33 }, "2024": { "paid_per_line_wavg": 619.31, "median_cell": 640.36, "p25": 586.43, "p75": 666.45, "lines": 725, "patients": 615, "n_providers": 5, "n_cells": 26 } } }, { "state": "Wyoming", "code": "WY", "quality_flag": "ok", "quality_evidence": null, "latest": null, "confidence": null, "official_fee": { "price_type": "official_fee", "fee_usd": 837.63, "fee_alt_usd": null, "fee_alt_label": null, "effective_date": "2026-07-01", "source_url": "https://www.wyomingmedicaid.com/portal/sites/default/files/inline-files/Fee_Schedules/FeeSchedule.xlsx", "source_kind": "xlsx", "sha256": "d57bdd8bbc8918155d4d29ee6a55ff56b38ffee8eb12f2a524604afdd27106e2", "ada_index_as_of": "2025-09-01", "column_note": "XLSX master schedule substituted for the ADA-indexed PDF (which carries no dental codes); effective date = latest active rate begin date", "ratio_fee_to_paid": null }, "by_year": { "2022": { "paid_per_line_wavg": 360.46, "median_cell": 360.46, "p25": 360.46, "p75": 360.46, "lines": 17, "patients": 12, "n_providers": 1, "n_cells": 1 } } } ], "caveats": [ "Paid amount per claim line, not an allowed amount, a fee-schedule rate or a cash price.", "Managed-care encounters may carry nominal paid amounts in some states (see quality_flag).", "HHS suppresses cells below 12 claim lines or 12 patients: provider participation is a floor, small states are incomplete.", "Provider state = current NPPES practice address (Aug 2026), not the address at time of service.", "2024 data are preliminary. CHIP included. No dual-eligible / third-party-liability flags.", "States may use non-NPI provider identifiers (notably Michigan): those dollars cannot be geolocated.", "official_fee (where present) is the state's published Medicaid dental fee-for-service rate for this code (source_url, sha256, effective_date attached); it is not what was paid per claim line and the two differ by design (managed care, bundling, rate years)." ] }