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Colorado rates for HCPCS D4263

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$188.74 / $188.74 / $188.74
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$124.82 / $188.74 / $198.70
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$206.55 / $206.55 / $206.55
Denver HMP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$179.52 / $195.02 / $290.66
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$155.00 / $155.00 / $329.00