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Massachusetts rates for HCPCS D0120

Periodic Oral Evaluation - Established Patient

Facilitymedian $39 · 10th–90th $23–$1100%20%10th90th$39Professionalmedian $18 · 10th–90th $13–$550%10%20%10th90th$18$10.0$20.0$50.0$100.0

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
$22.91 / $22.91 / $22.91
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.02 / $15.85 / $34.67
AllWays Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$14.13 / $109.65 / $141.25
AllWays Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.22 / $38.90 / $109.65
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$37.15 / $40.74 / $47.86
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$43.65 / $46.77 / $46.77
Fallon Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$20.42 / $26.92 / $87.10
Fallon Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$20.42 / $20.42 / $26.92
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$24.55 / $44.67 / $64.57
Mass General Brigham
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$14.13 / $109.65 / $141.25
Mass General Brigham
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.22 / $38.90 / $109.65
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.92 / $32.36 / $50.12