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Michigan rates for HCPCS D0120

Periodic Oral Evaluation - Established Patient

Facilitymedian $15 · 10th–90th $15–$150%50%100%$15Professionalmedian $16 · 10th–90th $13–$330%20%10th90th$16$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.14 / $15.14 / $15.14
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.88 / $15.85 / $34.67
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.05 / $19.05 / $19.05
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.14 / $15.14 / $15.14
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.02 / $15.14 / $25.70
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.05 / $19.05 / $19.05
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.90 / $33.88 / $42.66