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Missouri rates for HCPCS D0120

Periodic Oral Evaluation - Established Patient

Facilitymedian $19 · 10th–90th $15–$410%10%20%10th90th$19Professionalmedian $16 · 10th–90th $12–$300%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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.88 / $15.85 / $30.90
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.76 / $18.62 / $28.84
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.84 / $37.15 / $44.67
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$14.79 / $19.50 / $40.74
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$24.55 / $109.65 / $109.65