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Pennsylvania 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

Facilitymedian $355 · 10th–90th $355–$5,0120%50%90th$355Professionalmedian $339 · 10th–90th $288–$5370%20%40%10th90th$339$1.0$10.0$100.0$1.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$354.81 / $354.81 / $354.81
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $338.84 / $537.03
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $8,511.38 / $77,624.71
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$478.63 / $489.78 / $489.78
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$489.78 / $489.78 / $489.78
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$354.81 / $354.81 / $354.81
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $338.84 / $549.54
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $0.60 / $794.33