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South Dakota 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 $355 · 10th–90th $355–$6030%50%90th$355Professionalmedian $355 · 10th–90th $331–$4790%20%40%10th90th$355$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$354.81 / $354.81 / $354.81
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$331.13 / $346.74 / $478.63
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$389.05 / $588.84 / $954.99
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $645.65 / $2,398.83
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$537.03 / $645.65 / $758.58
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $758.58 / $758.58
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $812.83 / $812.83