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Illinois 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 $295 · 10th–90th $295–$2,3990%50%90th$295Professionalmedian $347 · 10th–90th $269–$5620%20%10th90th$347$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
Facility
Modifier
Typical Low / Median / Typical High
$295.12 / $295.12 / $295.12
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $346.74 / $478.63
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$933.25 / $2,238.72 / $2,691.53
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $1,348.96 / $1,737.80
Hally Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $30.20