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Idaho rates for HCPCS D4263

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

Facilitymedian $234 · 10th–90th $158–$8130%10%20%10th90th$234Professionalmedian $195 · 10th–90th $166–$3800%20%40%10th90th$195$50.0$100.0$200.0$500.0$1.0K$2.0K

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
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $194.98 / $234.42
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$524.81 / $724.44 / $1,698.24
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $380.19 / $380.19
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $194.98 / $281.84
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $194.98 / $602.56
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $30.20
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $331.13 / $4,265.80