go back

Kansas rates for HCPCS D4264

Bone Replacement Graft - Retained Natural Tooth - Each Additional Site In Quadrant

Facilitymedian $162 · 10th–90th $138–$2450%50%10th90th$162Professionalmedian $162 · 10th–90th $135–$3090%10%20%10th90th$162$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$162.18 / $162.18 / $162.18
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $154.88 / $199.53
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $309.03 / $309.03
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$134.90 / $181.97 / $316.23
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $1,047.13 / $1,047.13