go back

Oregon rates for HCPCS D4263

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$159.87 / $179.52 / $194.25
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$393.72 / $458.57 / $550.15
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$194.25 / $259.38 / $415.83
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$346.68 / $346.68 / $346.68
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$258.08 / $406.69 / $430.14
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$194.25 / $258.75 / $417.64
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$477.11 / $2,250,000.00 / $2,400,000.00