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Nebraska rates for HCPCS D4263

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

Facilitymedian $398 · 10th–90th $155–$4,1690%10%10th90th$398Professionalmedian $186 · 10th–90th $155–$2880%20%10th90th$186$200.0$500.0$1.0K$2.0K$5.0K

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
$154.88 / $154.88 / $154.88
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $162.18 / $257.04
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,041.74 / $2,691.53 / $5,248.07
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $288.40 / $446.68
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$154.88 / $275.42 / $407.38
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $1,288.25 / $1,288.25
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $309.03 / $501.19
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$524.81 / $524.81 / $524.81
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $407.38 / $457.09