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New Hampshire rates for HCPCS D0120

Periodic Oral Evaluation - Established Patient

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.88 / $18.07 / $24.33
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.84 / $27.00 / $32.20
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.87 / $47.49 / $89.11