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Utah 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 $447 · 10th–90th $447–$4470%50%100%$447Professionalmedian $372 · 10th–90th $302–$5130%20%10th90th$372$50.0$100.0$200.0$500.0

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
$446.68 / $446.68 / $446.68
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $346.74 / $512.86
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $44.67 / $776.25
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$676.08 / $707.95 / $707.95
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$426.58 / $467.74 / $524.81