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South Carolina 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 $1,175 · 10th–90th $324–$3,3880%10%10th90th$1,175Professionalmedian $339 · 10th–90th $302–$4470%20%40%10th90th$339$50.0$100.0$200.0$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$323.59 / $323.59 / $323.59
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $338.84 / $446.68
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$933.25 / $1,905.46 / $3,890.45
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$323.59 / $457.09 / $724.44
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $54.95