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Alaska 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 $525 · 10th–90th $331–$7590%20%10th90th$525Professionalmedian $363 · 10th–90th $295–$5250%20%10th90th$363$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
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $363.08 / $524.81
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$331.13 / $524.81 / $758.58
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $398.11 / $575.44
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,096.48 / $1,096.48
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$331.13 / $524.81 / $758.58
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $60.26 / $575.44