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Illinois rates for HCPCS D4261

Osseous Surg 1-3 Contig/Tooth Bound Spaces-Quad

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$224.25 / $224.25 / $224.25
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$202.43 / $241.63 / $348.69
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,887.73 / $4,864.60 / $5,983.73
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$292.97 / $292.97 / $292.97
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$345.40 / $845.93 / $1,053.90
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.00 / $2,500.00 / $2,500.00