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Mississippi rates for HCPCS D4263

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$118.94 / $118.94 / $207.67
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$118.94 / $179.46 / $231.88
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$593.75 / $593.75 / $593.75
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$630.00 / $630.00 / $630.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.00 / $21.25 / $50.00