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Missouri 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 $427 · 10th–90th $363–$8910%20%10th90th$427Professionalmedian $355 · 10th–90th $282–$4900%10%20%10th90th$355$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
$363.08 / $426.58 / $426.58
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $346.74 / $426.58
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $467.74 / $676.08
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $691.83 / $691.83
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$346.74 / $501.19 / $1,318.26
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $2,398.83 / $2,398.83