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Minnesota rates for HCPCS D4263

Bone Repl Graft - Ret Nat Tooth - 1st Site Quad

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$204.64 / $204.64 / $204.64
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$162.19 / $204.64 / $234.97
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$797.53 / $1,531.84 / $3,715.45
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$656.37 / $773.60 / $797.53
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$196.71 / $251.40 / $420.26
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$311.49 / $1,274.00 / $1,274.00