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Virginia 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
$322.57 / $546.63 / $546.63
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$322.57 / $427.56 / $546.63
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$945.00 / $945.00 / $1,446.60
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$635.50 / $635.50 / $1,239.22
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$534.89 / $534.89 / $534.89
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$339.28 / $434.16 / $513.10
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$335.96 / $515.69 / $832.52
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$492.00 / $698.00 / $837.00
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$343.07 / $474.98 / $1,291.00
Sentara
Facility/Professional
Professional
Modifier
Low / Median / High Price
$343.07 / $506.55 / $4,071.00