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Kentucky 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
$135.74 / $202.35 / $202.35
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$148.15 / $199.88 / $232.29
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$300.00 / $430.95 / $507.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.00 / $45.00 / $3,000.00