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Mississippi rates for HCPCS D4263

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

Facilitymedian $117 · 10th–90th $117–$2090%50%90th$117Professionalmedian $195 · 10th–90th $117–$2090%20%10th90th$195$20.0$50.0$100.0$200.0$500.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$117.49 / $117.49 / $208.93
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $194.98 / $208.93
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$588.84 / $588.84 / $588.84
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $630.96 / $630.96
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21.38 / $25.12 / $50.12