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Florida rates for HCPCS D4263

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

Facilitymedian $155 · 10th–90th $120–$6760%20%40%10th90th$155Professionalmedian $178 · 10th–90th $126–$2290%20%10th90th$178$50.0$100.0$200.0$500.0

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
$120.23 / $154.88 / $154.88
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $177.83 / $229.09
AvMed
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$331.13 / $676.08 / $676.08
Florida Blue
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$758.58 / $812.83 / $870.96
Florida Blue
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $173.78 / $218.78
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $39.81 / $50.12
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $208.93 / $208.93