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Maine rates for HCPCS D4263

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

Professionalmedian $209 · 10th–90th $151$4070%10%20%10th90th$209$100.0$200.0$500.0$1.0K

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
$151.36 / $186.21 / $295.12
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $208.93 / $398.11
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $331.13 / $741.31
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $190.55 / $295.12