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Massachusetts 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
$649.54 / $649.54 / $649.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$289.50 / $649.54 / $675.97
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$579.03 / $717.64 / $1,693.87
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$553.19 / $1,155.17 / $2,436.69
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$534.89 / $534.89 / $534.89
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.43 / $4,618.00 / $9,239.00
Fallon Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$482.83 / $568.03 / $568.03
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$759.72 / $1,430.86 / $1,770.15
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$705.58 / $705.58 / $16,547.20
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,436.69 / $2,436.69 / $2,436.69