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Nebraska rates for HCPCS D0120

Periodic Oral Evaluation - Established Patient

Facilitymedian $21 · 10th–90th $13–$420%10%10th90th$21Professionalmedian $15 · 10th–90th $13–$230%20%10th90th$15$10.0$20.0$50.0$100.0$200.0

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 / $12.88 / $12.88
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.88 / $15.14 / $19.95
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$257.04 / $269.15 / $354.81
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.88 / $37.15 / $37.15
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$13.18 / $20.42 / $30.20
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.18 / $109.65 / $109.65
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.44 / $28.18 / $41.69
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21.88 / $28.84 / $41.69
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.90 / $30.90 / $30.90
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.70 / $26.92 / $37.15