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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
$215.19 / $215.19 / $238.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$204.20 / $238.50 / $265.20
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$479.34 / $1,492.08 / $1,492.08
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,712.50 / $1,712.50 / $2,372.17
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$231.44 / $307.83 / $511.62
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$262.39 / $262.39 / $262.39
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$232.17 / $308.41 / $511.62
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$262.39 / $356.73 / $2,250,000.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$991.00 / $991.00 / $991.00
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$377.00 / $377.00 / $508.95