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Pedicle Gum Tissue Graft

Indiana rates for HCPCS D4270

A gum surgery that moves healthy tissue from next to a receded area over to cover an exposed tooth root, keeping the tissue attached at one edge so it keeps its own blood supply. It is used to treat gum recession, protect the root from sensitivity and further wear, and improve the appearance of the gumline.

Rates data updated October 2026.

How much does Pedicle Gum Tissue Graft cost?

$501

Typical negotiated rate. In Indiana, October 2026.

Insurers have agreed to pay about $501 for this service. The price depends on where it is billed: about $501 from a physician practice, and about $1,000 from a hospital or other facility.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 4 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$501$501 to $550
FacilityA hospital or hospital-owned outpatient department$1,000$501 to $2,138

How much rates vary

Facilitymedian $1,000 · 10th to 90th $245 to $4,786Professionalmedian $501 · 10th to 90th $191 to $741
$200$500$1K$2K$5Kfacility $1,000professional $501

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$190.55
Median
$190.55
Typical High
$190.55
Aetna
Setting
Professional
Modifier
None
Typical Low
$190.55
Median
$190.55
Typical High
$263.03
Anthem BCBS
Setting
Facility
Modifier
None
Typical Low
$501.19
Median
$4,786.30
Typical High
$6,309.57
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$501.19
Median
$501.19
Typical High
$758.58
Cigna
Setting
Facility
Modifier
None
Typical Low
$245.47
Median
$251.19
Typical High
$302.00
Physicians Health Plan of Northern Indiana
Setting
Facility
Modifier
None
Typical Low
$575.44
Median
$1,230.27
Typical High
$2,137.96
Physicians Health Plan of Northern Indiana
Setting
Professional
Modifier
None
Typical Low
$72.44
Median
$380.19
Typical High
$562.34

Where Indiana sits

The same service costs 9.5 times more in Texas than in New Jersey. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Indiana· 17th of 51

$501

TX $1,820NJ $191

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.