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Maine rates for HCPCS D4261

Osseous Surgery (Including Elevation Of A Full Thickness Flap And Closure) - One To Three Contiguous Teeth Or Tooth Bounded Spaces Per Quadrant

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$186.21 / $245.47 / $416.87
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$269.15 / $380.19 / $575.44
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$407.38 / $501.19 / $794.33
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$239.88 / $346.74 / $416.87