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Maine rates for HCPCS D4273

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

Professionalmedian $575 · 10th–90th $302$9770%10%10th90th$575$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 / $398.11 / $645.65
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$389.05 / $457.09 / $933.25
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $794.33 / $1,230.27
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $398.11 / $645.65