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North Carolina rates for HCPCS D4263

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$199.72 / $199.72 / $199.72
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$165.77 / $199.72 / $231.88
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$873.33 / $873.33 / $886.08
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$182.13 / $234.74 / $422.54
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$139.69 / $169.70 / $279.14
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$155.75 / $155.75 / $272.00
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$276.30 / $276.30 / $276.30
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$367.69 / $5,062.89 / $5,062.89
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,274.00 / $1,820.10 / $1,820.10