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New Hampshire 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 $646 · 10th–90th $302–$1,4130%5%10%10th90th$646$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
$281.84 / $346.74 / $575.44
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $562.34 / $794.33
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $1,096.48 / $1,698.24