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Nationwide rates for HCPCS D4273

Autogenous Connective Tissue Graft Procedure (Including Donor And Recipient Surgical Sites) First Tooth, Implant, Or Edentulous Tooth Position In Graft

Facilitymedian $562 · 10th–90th $324–$4,4670%20%10th90th$562Professionalmedian $372 · 10th–90th $295–$8320%50%10th90th$372$0.5$5.0$50.0$500.0$5.0K$50.0K$500.0K

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
$295.12 / $346.74 / $562.34
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $346.74 / $478.63
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$549.54 / $4,786.30 / $6,309.57
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $549.54 / $912.01
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$50,118.72 / $50,118.72 / $53,703.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$371.54 / $467.74 / $467.74
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$524.81 / $741.31 / $758.58

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