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Massachusetts rates for HCPCS D4263

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

Facilitymedian $234 · 10th–90th $234–$1,9500%50%90th$234Professionalmedian $229 · 10th–90th $155–$5370%10%10th90th$229$100.0$500.0$2.0K$10.0K$50.0K

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
Facility
Modifier
Typical Low / Median / Typical High
$234.42 / $234.42 / $234.42
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $190.55 / $234.42
AllWays Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$208.93 / $691.83 / $1,949.84
AllWays Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $354.81 / $1,288.25
Fallon Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$60.26 / $3,630.78 / $8,511.38
Fallon Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $288.40 / $338.84
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $407.38 / $602.56
Mass General Brigham
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$208.93 / $691.83 / $1,949.84
Mass General Brigham
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $354.81 / $1,288.25