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Minnesota rates for HCPCS D4263

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

Facilitymedian $2,188 · 10th–90th $204–$6,4570%5%10%10th90th$2,188Professionalmedian $794 · 10th–90th $170–$7940%50%10th$794$200.0$500.0$1.0K$2.0K$5.0K$10.0K

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
$204.17 / $204.17 / $204.17
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $181.97 / $234.42
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$812.83 / $3,019.95 / $7,585.78
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $794.33 / $794.33
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$154.88 / $229.09 / $389.05
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $1,288.25 / $1,288.25