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Idaho 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 $589 · 10th–90th $363–$1,6980%10%10th90th$589Professionalmedian $363 · 10th–90th $302–$7240%20%10th90th$363$50.0$100.0$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
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $363.08 / $478.63
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$562.34 / $776.25 / $1,698.24
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $851.14 / $851.14
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$354.81 / $467.74 / $645.65
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $363.08 / $478.63
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $30.20
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$524.81 / $2,041.74 / $3,801.89