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Oklahoma rates for HCPCS D4273

Autogenous Connective Tissue Graft Procedure

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$310.47 / $310.47 / $310.47
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$310.47 / $310.47 / $314.12
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$310.47 / $329.83 / $646.92
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$364.01 / $695.33 / $2,390.37