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Iowa 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 $417 · 10th–90th $339–$9770%20%40%10th90th$417Professionalmedian $355 · 10th–90th $282–$5620%10%20%10th90th$355$200.0$500.0$1.0K$2.0K

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
$338.84 / $338.84 / $338.84
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $354.81 / $478.63
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,230.27 / $1,737.80
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$416.87 / $660.69 / $1,288.25
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$537.03 / $691.83 / $2,398.83
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$467.74 / $645.65 / $977.24
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$645.65 / $977.24 / $1,071.52
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $812.83 / $812.83