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Texas 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
$213.80 / $218.78 / $239.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$204.17 / $245.47 / $316.23
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,698.24 / $1,698.24 / $1,698.24
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,698.24 / $2,398.83 / $2,398.83
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$229.09 / $309.03 / $524.81
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$204.17 / $245.47 / $281.84
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $30.20 / $30.20
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$275.42 / $275.42 / $275.42
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$229.09 / $309.03 / $501.19
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $269.15 / $436.52
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$380.19 / $380.19 / $851.14