Fabrication of Athletic Mouthguard (D9941) in Indiana

Name: Fabrication of Athletic Mouthguard (D9941) Reimbursement Rates in Indiana — PayorMap
Creator: PayorMap
License: https://creativecommons.org/publicdomain/mark/1.0/
Keywords: fabrication of athletic mouthguard cost, fabrication of athletic mouthguard reimbursement rate, D9941 PPO rate, fabrication of athletic mouthguard negotiated rate, D9941 fee schedule, dental fabrication of athletic mouthguard price, D9941 dental insurance rate

Negotiated reimbursement rates for D9941 from CMS Transparency in Coverage data. Based on 29 rate records from 29 providers in Indiana.

Average Negotiated Rate in Indiana

$104

29 rate records · 29 providers

📊 Data updated monthly · Last refresh: March 2026

Provider-Level Rates

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Individual provider rates for D9941 in Indiana. 28 provider records.

Provider	City	Rate	Percentile
Basel HajjarPeriodontist	Valparaiso	$178	100th
Bogun LeeGeneral Dentist	Merrillville	$119	97th
Rekha ChaudhariGeneral Dentist	Indianapolis	$119	97th
Arnel GallanosaGeneral Dentist	Indianapolis	$119	97th
Thomas BrittonGeneral Dentist	Lafayette	$119	97th
Varun Reddy ChintakuntaGeneral Dentist	Carmel	$119	97th
Tayseer HamiedGeneral Dentist	Frankfort	$119	97th
Brynn WhalenGeneral Dentist	Indianapolis	$119	97th
Charles SchindlerGeneral Dentist	Columbus	$119	97th
Dhruv PatelGeneral Dentist	Trafalgar	$119	97th
Neha PooniaGeneral Dentist	North Vernon	$119	97th
Hanady NazzalGeneral Dentist	Carmel	$119	97th
Heidy Castellanos GironGeneral Dentist	Indianapolis	$119	97th
Anjesha Antony AlappattGeneral Dentist	Indianapolis	$119	97th
Rob JaynesGeneral Dentist	Indianapolis	$119	97th
Marfaa AlmjamaieGeneral Dentist	Indianapolis	$119	97th
Harpravjeet MalhiDental Lab	Indianapolis	$79	41st
Milan ShethGeneral Dentist	Indianapolis	$79	41st
Gurusharan SinghGeneral Dentist	Indianapolis	$79	41st
Yacoub AljobehGeneral Dentist	Indianapolis	$79	41st

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What is D9941?

Fabrication of Athletic Mouthguard (CDT Code D9941) — These rates represent negotiated amounts between dental insurance payors and providers in Indiana as reported in CMS Transparency in Coverage machine-readable files.

Top States for D9941

Oklahoma

$170

1 records

Nevada

$167

18 records

Oregon

$155

5 records

40+ more states available with Pro ↓

Full Rate Breakdown

Median Rate

$119

Low

$79

High

$178

25th Percentile

$79

75th Percentile

$119

Data Points

Compare D9941 Rates Across All 43 States

Oklahoma

$170

Nevada

$167

Oregon

$155

Colorado

$151

California

$148

Florida

$143

Alaska

$128

Connecticut

$126

New York

$126

Kentucky

$125

South Carolina

$125

New Mexico

$123

Arizona

$122

Massachusetts

$119

Washington

$116

District of Columbia

$114

New Jersey

$107

Michigan

$106

Georgia

$105

Wisconsin

$105

Indiana

$104

Illinois

$104

Pennsylvania

$104

Maine

$104

North Carolina

$102

Texas

$99

Maryland

$95

Tennessee

$91

New Hampshire

$85

Alabama

$84

Ohio

$82

Utah

$80

Virginia

$74

Missouri

$73

Idaho

$72

Delaware

$71

Louisiana

$64

North Dakota

$62

Iowa

$55

Nebraska

$51

Kansas

$47

South Dakota

$43

Minnesota

$42

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