Bone Graft For Gum Disease — First Site

Minnesota rates for HCPCS D4263

Placement of bone graft material into an area where gum disease has caused bone loss around a tooth, done to help rebuild lost bone and support for the tooth. This describes the graft placed at the first site treated within one section of the mouth during the same procedure, with any additional sites in that area handled as their own step. It's typically done alongside gum surgery rather than as a stand-alone visit.

Rates data updated October 2026.

How much does Bone Graft For Gum Disease — First Site cost?

$661

Typical negotiated rate. In Minnesota, October 2026.

Insurers have agreed to pay about $661 for this service. The price depends on where it is billed: about $661 from a physician practice, and about $282 from a hospital or other facility.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 3 insurance carriers under federal price transparency rules.

Prices by location type

Billed by	Who charges it	Typical	Range
Physician practiceA doctor's office, clinic or independent provider	A doctor's office, clinic or independent provider	$661	$204 to $813
FacilityA hospital or hospital-owned outpatient department	A hospital or hospital-owned outpatient department	$282	$204 to $2,188

How much rates vary

Facilitymedian $282 · 10th to 90th $204 to $5,012Professionalmedian $661 · 10th to 90th $204 to $813

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier	Facility/Professional	Modifier	Typical Low	Median	Typical High
Aetna Setting Facility Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17	Facility	None	$204.17	$204.17	$204.17
Aetna Setting Professional Modifier None Typical Low $181.97 Median $204.17 Typical High $204.17	Professional	None	$181.97	$204.17	$204.17
BCBS Minnesota Setting Facility Modifier None Typical Low $812.83 Median $2,630.27 Typical High $6,309.57	Facility	None	$812.83	$2,630.27	$6,309.57
BCBS Minnesota Setting Professional Modifier None Typical Low $645.65 Median $741.31 Typical High $812.83	Professional	None	$645.65	$741.31	$812.83
Medica Setting Facility Modifier None Typical Low $204.17 Median $331.13 Typical High $5,011.87	Facility	None	$204.17	$331.13	$5,011.87
Medica Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25	Professional	None	$1,288.25	$1,288.25	$1,288.25

Where Minnesota sits

The same service costs 10.2 times more in Texas than in Vermont. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Minnesota· 2nd of 51

$661

TX $1,288VT $126

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.