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Oklahoma rates for HCPCS D4263

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$165.46 / $165.46 / $165.46
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$165.46 / $167.41 / $202.35
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$155.58 / $173.73 / $265.97
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$136.01 / $219.37 / $1,274.00