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Arizona rates for HCPCS D4263

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$164.93 / $178.06 / $196.71
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$165.77 / $202.35 / $361.46
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,274.00 / $1,274.00 / $1,274.00