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Ohio 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 $347 · 10th–90th $347–$3470%50%$347Professionalmedian $407 · 10th–90th $282–$7760%10%10th90th$407$50.0$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$346.74 / $346.74 / $346.74
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $331.13 / $478.63
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $676.08 / $1,000.00
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$436.52 / $436.52 / $436.52
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $50.12 / $60.26
SummaCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,905.46 / $1,905.46 / $1,905.46
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $60.26 / $75.86