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Oregon rates for HCPCS D4263

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

Facilitymedian $417 · 10th–90th $195–$4170%20%40%10th$417Professionalmedian $186 · 10th–90th $158–$2340%50%10th90th$186$100.0$500.0$2.0K$10.0K$50.0K$200.0K$1.0M

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
$194.98 / $194.98 / $194.98
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $181.97 / $229.09
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $467.74 / $537.03
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $218.78 / $389.05
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $186.21 / $346.74
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$281.84 / $416.87 / $426.58
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $234.42 / $389.05
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $79.43 / $616.60