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New Hampshire rates for HCPCS D4263

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

Professionalmedian $269 · 10th–90th $151$5130%5%10%10th90th$269$100.0$200.0$500.0$1.0K

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $181.97 / $295.12
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $229.09 / $331.13
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $407.38 / $588.84