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Georgia rates for HCPCS D4263

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

Facilitymedian $170 · 10th–90th $170–$1700%50%100%$170Professionalmedian $186 · 10th–90th $148–$2450%50%10th90th$186$1.0$5.0$20.0$100.0$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
$169.82 / $169.82 / $169.82
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $181.97 / $234.42
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $204.17 / $338.84
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $229.09 / $363.08