go back

Wisconsin 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 $214 · 10th–90th $209–$5500%50%10th90th$214Professionalmedian $269 · 10th–90th $209–$8130%10%20%10th90th$269$100.0$200.0$500.0$1.0K$2.0K

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
$208.93 / $208.93 / $208.93
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $245.47 / $346.74
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $457.09 / $912.01
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$213.80 / $269.15 / $537.03
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $186.21
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$213.80 / $269.15 / $549.54
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $1,698.24 / $1,698.24
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $54.95 / $70.79
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $660.69 / $977.24
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$501.19 / $501.19 / $1,698.24
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,258.93 / $1,698.24 / $1,698.24
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $707.95 / $758.58