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California rates for HCPCS D4260

Osseous Surgery (Including Elevation Of A Full Thickness Flap And Closure) - Four Or More Contiguous Teeth Or Tooth Bounded Spaces Per Quadrant

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$500.98 / $534.71 / $534.71
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$312.16 / $460.44 / $534.71
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$462.47 / $673.00 / $1,058.25
Blue Shield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$97.00 / $1,034.25 / $2,572.80
Blue Shield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$481.60 / $688.00 / $1,504.04
Contra Costa Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,090.27 / $4,090.27 / $4,294.78
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$393.93 / $638.07 / $801.00
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$705.58 / $16,547.20 / $16,547.20
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,436.69 / $2,436.69 / $3,067.50
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.00 / $70.00 / $85.00
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$421.49 / $509.69 / $693.94
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$362.84 / $2,250,000.00 / $2,400,000.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$470.00 / $512.00 / $951.56