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Utah 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

Facilitymedian $240 · 10th–90th $240–$2400%50%100%$240Professionalmedian $257 · 10th–90th $234–$3470%20%10th90th$257$50.0$100.0$200.0$500.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$239.88 / $239.88 / $239.88
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $257.04 / $323.59
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $44.67 / $416.87
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$371.54 / $380.19 / $380.19
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$331.13 / $389.05 / $407.38