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South Carolina 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
$239.88 / $239.88 / $239.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$186.21 / $239.88 / $281.84
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,949.84 / $4,570.88 / $8,709.64
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$234.42 / $302.00 / $512.86
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $54.95 / $54.95