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Ohio 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
$261.23 / $261.23 / $1,362.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$247.54 / $261.23 / $293.23
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$672.00 / $772.80 / $1,239.23
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13,362.61 / $13,362.61 / $16,297.02
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.00 / $50.00 / $60.00