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Oklahoma rates for HCPCS D4263

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

Facilitymedian $166 · 10th–90th $166–$2340%50%90th$166Professionalmedian $178 · 10th–90th $155–$2340%50%10th90th$178$100.0$500.0$2.0K$10.0K$50.0K$200.0K

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
Facility
Modifier
Typical Low / Median / Typical High
$165.96 / $165.96 / $165.96
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $177.83 / $234.42
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$154.88 / $173.78 / $338.84
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $218.78 / $1,288.25