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Missouri 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
$259.76 / $319.51 / $319.51
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$215.19 / $259.76 / $319.51
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$226.01 / $305.64 / $431.71
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$287.10 / $287.10 / $287.10
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$239.21 / $335.49 / $729.93
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,712.50 / $1,712.50 / $1,712.50