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California rates for HCPCS D0120

Periodic Oral Evaluation - Established Patient

Facilitymedian $20 · 10th–90th $14–$350%10%10th90th$20Professionalmedian $19 · 10th–90th $14–$480%10%10th90th$19$10.0$20.0$50.0$100.0$200.0$500.0

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
$12.88 / $15.85 / $15.85
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.88 / $18.20 / $39.81
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17.38 / $25.12 / $33.11
Blue Shield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.18 / $36.31 / $63.10
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $398.11 / $831.76
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$109.65 / $109.65 / $109.65
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $138.04 / $138.04
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$24.55 / $28.18 / $60.26
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $54.95 / $70.79
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$14.45 / $20.42 / $29.51
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17.78 / $60.26 / $79.43
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$24.55 / $32.36 / $39.81