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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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$317.06 / $355.51 / $355.51
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$264.81 / $322.57 / $486.76
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,000.00 / $8,639.91 / $79,506.39
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$476.52 / $494.51 / $494.51
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$355.51 / $355.51 / $355.51
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$264.81 / $335.96 / $509.69
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$660.00 / $722.70 / $722.70