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Gum Tissue Graft From Own Mouth, First Site

Tennessee rates for HCPCS D4273

A dental procedure that takes a small piece of the patient's own tissue and grafts it onto the gums at a tooth, implant, or toothless position. This charge covers the first site treated and includes the work at both the donor and recipient areas.

Rates data updated October 2026.

How much does Gum Tissue Graft From Own Mouth, First Site cost?

$692

Typical physician fee. In Tennessee, October 2026.

Insurers have agreed to pay about $692 for this service. Most negotiated rates run $339 to $2,399.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 3 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $339 · 10th to 90th $339 to $339Professionalmedian $692 · 10th to 90th $302 to $3,236
$200$500$1K$2Kfacility $339professional $692

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$338.84
Median
$338.84
Typical High
$338.84
Aetna
Setting
Professional
Modifier
None
Typical Low
$218.78
Median
$338.84
Typical High
$354.81
BCBS Tennessee
Setting
Professional
Modifier
None
Typical Low
$691.83
Median
$691.83
Typical High
$691.83
Lucent Health
Setting
Professional
Modifier
None
Typical Low
$2,398.83
Median
$2,398.83
Typical High
$3,235.94

Where Tennessee sits

The same service costs 9.5 times more in Texas than in West Virginia. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Tennessee· 14th of 51

$692

TX $2,399WV $251

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.