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Maryland rates for HCPCS D4273

Autogenous Connective Tissue Graft Procedure (Including Donor And Recipient Surgical Sites) First Tooth, Implant, Or Edentulous Tooth Position In Graft

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$328.68 / $332.41 / $374.75
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$478.80 / $478.80 / $612.86
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$387.50 / $499.88 / $868.55