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Montana 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
Professional
Modifier
Low / Median / High Price
$375.01 / $421.31 / $421.31
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$388.91 / $850.08 / $850.08
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$375.58 / $563.42 / $859.65