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Idaho rates for HCPCS D4273

Autogenous Connective Tissue Graft Procedure

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$364.27 / $395.99 / $479.01
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$357.83 / $466.27 / $613.13
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $2,000.00 / $3,900.00