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Michigan 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
$319.61 / $319.61 / $319.61
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$289.50 / $319.61 / $477.48
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$534.89 / $534.89 / $581.62
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$319.61 / $319.61 / $319.61
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$312.16 / $319.61 / $381.99
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $30.00 / $55.00