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Tennessee rates for HCPCS D4273

Autogenous Connective Tissue Graft Procedure (Including Donor And Recipient Surgical Sites) First Tooth, Implant, Or Edentulous Tooth Position In Graft

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$220.67 / $342.04 / $342.04
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$220.67 / $342.04 / $367.78
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$697.00 / $697.00 / $1,637.95
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$669.47 / $3,728.65 / $3,728.65
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,390.37 / $2,390.37 / $3,160.73