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New Mexico 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
$309.43 / $309.43 / $309.43
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$300.10 / $309.43 / $500.98
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.00 / $433.23 / $1,500.00
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$318.08 / $513.36 / $640.54
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,400,000.00 / $2,400,000.00 / $2,400,000.00