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Mississippi rates for HCPCS D4264

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

Facilitymedian $98 · 10th–90th $98–$1700%50%90th$98Professionalmedian $155 · 10th–90th $98–$1700%20%40%10th90th$155$20.0$50.0$100.0

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
$97.72 / $97.72 / $169.82
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $162.18 / $169.82
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $74.13 / $74.13
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21.38 / $25.12 / $50.12