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Tennessee rates for HCPCS D4264

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

Facilitymedian $1,047 · 10th–90th $138–$1,0470%50%10th$1,047Professionalmedian $151 · 10th–90th $112–$2690%20%10th90th$151$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
$89.13 / $138.04 / $138.04
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $144.54 / $190.55
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $269.15 / $269.15
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,047.13 / $1,047.13
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,479.11 / $1,479.11