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New Mexico 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 $525 · 10th–90th $302–$9770%5%10%10th90th$525Professionalmedian $331 · 10th–90th $302–$3980%20%10th90th$331$100.0$200.0$500.0$1.0K

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
$302.00 / $302.00 / $302.00
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $331.13 / $398.11
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $70.79 / $85.11
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$302.00 / $524.81 / $977.24