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New York rates for HCPCS D0120

Periodic Oral Evaluation - Established Patient

Facilitymedian $12 · 10th–90th $11–$140%20%40%10th90th$12Professionalmedian $18 · 10th–90th $13–$370%10%10th90th$18$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
$10.96 / $12.02 / $13.80
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.02 / $15.85 / $43.65
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.22 / $19.05 / $25.12
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.12 / $36.31 / $36.31
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.98 / $18.62 / $26.92
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.91 / $32.36 / $39.81
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$14.13 / $16.60 / $16.60
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14.13 / $16.98 / $36.31