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Washington 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 $550 · 10th–90th $324–$11,2200%10%10th90th$550Professionalmedian $269 · 10th–90th $224–$5890%20%10th90th$269$50.0$200.0$1.0K$5.0K$20.0K

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$323.59 / $323.59 / $323.59
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $269.15 / $346.74
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$323.59 / $602.56 / $13,803.84
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $562.34 / $691.83
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $50.12 / $64.57
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$457.09 / $537.03 / $562.34
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$537.03 / $537.03 / $537.03