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Tennessee rates for HCPCS D4263

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

Facilitymedian $1,950 · 10th–90th $166–$1,9500%50%10th$1,950Professionalmedian $178 · 10th–90th $135–$2950%10%20%10th90th$178$100.0$200.0$500.0$1.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$107.15 / $165.96 / $165.96
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $177.83 / $229.09
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$380.19 / $380.19 / $380.19
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,949.84 / $1,949.84 / $1,949.84
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,819.70 / $1,819.70