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Tennessee rates for HCPCS D4263

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$108.25 / $167.79 / $167.79
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$108.25 / $167.79 / $202.35
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$378.00 / $378.00 / $888.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$191.28 / $191.28 / $191.28
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$367.69 / $5,062.89 / $5,062.89
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,274.00 / $1,274.00 / $1,820.10