Based on public Medicaid payment data.
Jesse G Grantz
Medicaid Provider in Fairmont, MN
Type
Individual Provider
Address
800 Medical Center Dr Ste 490
Fairmont, MN 560314575
Phone
5074323199
NPI
1912670472
Procedures
3
Total Claims
5.1K
Patients Served
4.7K
About these costs
All amounts reflect Medicaid reimbursement rates, which are typically much lower than private insurance or cash prices. These figures show what state Medicaid programs actually paid this provider per claim.
Procedures & Average Costs
| Procedure | Avg. Paid | Claims | Patients |
|---|---|---|---|
| Dental Cleaning & Exam | $50.22 | 3,765 | 3,752 |
| Dental Filling | $95.67 | 1,020 | 750 |
| Tooth Extraction | $111.58 | 350 | 188 |
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