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Michigan 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
Facility
Modifier
Low / Median / High Price
$245.47 / $245.47 / $245.47
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$204.17 / $245.47 / $323.59
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$245.47 / $245.47 / $245.47
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$204.17 / $245.47 / $323.59