go back

Nebraska 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 $2,291 · 10th–90th $275–$4,4670%5%10%10th90th$2,291Professionalmedian $324 · 10th–90th $269–$6460%20%40%10th90th$324$500.0$1.0K$2.0K$5.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$269.15 / $269.15 / $269.15
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $323.59 / $346.74
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,187.76 / $2,818.38 / $5,495.41
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$616.60 / $660.69 / $691.83
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$275.42 / $478.63 / $3,715.35
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$645.65 / $2,398.83 / $2,398.83
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$537.03 / $645.65 / $1,000.00
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$794.33 / $794.33 / $794.33