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North Dakota rates for HCPCS D4264

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

Facilitymedian $155 · 10th–90th $155–$2450%50%90th$155Professionalmedian $195 · 10th–90th $145–$3470%20%10th90th$195$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
$154.88 / $154.88 / $169.82
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $154.88 / $199.53
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $295.12 / $346.74
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$154.88 / $213.80 / $295.12
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,047.13 / $1,047.13