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California rates for HCPCS D4263

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

Facilitymedian $263 · 10th–90th $170–$1,9500%10%10th90th$263Professionalmedian $191 · 10th–90th $155–$4570%20%10th90th$191$100.0$200.0$500.0$1.0K$2.0K$5.0K

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
$177.83 / $177.83 / $190.55
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $181.97 / $229.09
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $213.80 / $426.58
Blue Shield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$741.31 / $1,445.44 / $3,235.94
Blue Shield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $416.87 / $776.25
Contra Costa Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$478.63 / $478.63 / $501.19
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $630.96 / $831.76
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,949.84 / $1,949.84 / $1,949.84
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,819.70 / $1,819.70
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $54.95 / $70.79
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$165.96 / $257.04 / $363.08
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $223.87 / $630.96
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $181.97 / $309.03