Periodic Oral Evaluation

Hawaii rates for HCPCS D0120

A routine check-up exam for a patient who has already been seen by the dental practice, usually done at recall visits every so often. The dentist checks for new cavities, gum changes, and overall oral health, and compares findings to prior visits. It is shorter than a full first-time evaluation since the patient's history is already on file.

Rates data updated October 2026.

How much rates vary

Professionalmedian $17 · 10th to 90th $14 to $33

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

Rates by insurance carrier

Insurance Carrier	Facility/Professional	Modifier	Typical Low	Median	Typical High
Aetna Setting Professional Modifier None Typical Low $13.80 Median $16.98 Typical High $33.11	Professional	None	$13.80	$16.98	$33.11
Kaiser Permanente Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08	Professional	None	$676.08	$676.08	$676.08