Rates› Pennsylvania› D6104

Bone Graft — Implant Repair (Each Add'l Site) (D6104) in Pennsylvania

Negotiated reimbursement rates for D6104 from CMS Transparency in Coverage data. Based on 12 rate records from 12 providers in Pennsylvania.

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Average Negotiated Rate in Pennsylvania
$153
12 rate records · 12 providers
📊 Data updated monthly · Last refresh: March 2026

Provider-Level Rates

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Individual provider rates for D6104 in Pennsylvania. 11 provider records.

Provider City Rate Percentile
Oral & Maxillofacial RadiologyCollegeville$215100th
General DentistEaston$20892nd
General DentistMedia$19083rd
General DentistBala Cynwyd$19083rd
Oral SurgeonDrexel Hill$17067th
Oral SurgeonDrexel Hill$17067th
General DentistWarminster$15950th
Oral SurgeonPittsburgh$13342nd
General DentistLansdale$12533rd
General DentistPittsburgh$9325th
General DentistHanover$9325th

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What is D6104?

Bone Graft — Implant Repair (Each Add'l Site) (CDT Code D6104) — These rates represent negotiated amounts between dental insurance payors and providers in Pennsylvania as reported in CMS Transparency in Coverage machine-readable files.

Top States for D6104

Virginia
$469
11 records
New York
$453
40 records
Nevada
$425
12 records

44+ more states available with Pro ↓

Full Rate Breakdown

Median Rate
$164
Low
$90
High
$215
25th Percentile
$117
75th Percentile
$190
Data Points
12

Compare D6104 Rates Across All 47 States

Virginia
$469
New York
$453
Nevada
$425
North Dakota
$375
Utah
$295
Alaska
$289
Connecticut
$274
New Jersey
$259
District of Columbia
$253
Washington
$246
Oregon
$242
Ohio
$232
Puerto Rico
$221
Indiana
$218
Minnesota
$212
South Carolina
$209
Delaware
$200
New Hampshire
$198
Arizona
$193
Florida
$190
Massachusetts
$189
Maryland
$189
Kentucky
$186
Louisiana
$185
California
$178
Michigan
$168
Rhode Island
$158
Pennsylvania
$153
New Mexico
$150
North Carolina
$147
Illinois
$139
Georgia
$137
Colorado
$132
Missouri
$132
Texas
$131
Maine
$124
Mississippi
$122
Idaho
$114
West Virginia
$112
Tennessee
$102
Oklahoma
$100
Alabama
$99
Arkansas
$88
Hawaii
$87
Nebraska
$81
Iowa
$78
Kansas
$74
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