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Nationwide rates for HCPCS D4263

Bone Replacement Graft - Retained Natural Tooth - First Site In Quadrant

Facilitymedian $240 · 10th–90th $162$2,0420%20%40%10th90th$240Professionalmedian $191 · 10th–90th $151$4270%50%10th90th$191$0.5$5.0$50.0$500.0$5.0K$50.0K$500.0K

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
$154.88 / $186.21 / $234.42
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $181.97 / $234.42
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$512.86 / $1,995.26 / $2,630.27
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $263.03 / $676.08
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$50,118.72 / $50,118.72 / $53,703.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $190.55 / $190.55
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $181.97 / $309.03