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Washington 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 $692 · 10th–90th $490–$1,5850%10%20%10th90th$692Professionalmedian $490 · 10th–90th $316–$9330%10%10th90th$490$50.0$200.0$1.0K$5.0K

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
$512.86 / $512.86 / $512.86
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $416.87 / $645.65
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$489.78 / $741.31 / $2,041.74
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$489.78 / $707.95 / $1,071.52
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $50.12 / $64.57
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$588.84 / $691.83 / $691.83
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,230.27 / $1,230.27 / $1,230.27