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Ohio rates for HCPCS D0120

Periodic Oral Evaluation - Established Patient

Facilitymedian $15 · 10th–90th $15–$150%50%$15Professionalmedian $19 · 10th–90th $13–$390%10%10th90th$19$10.0$20.0$50.0$100.0$200.0$500.0

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
$12.02 / $15.85 / $36.31
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.12 / $28.84 / $42.66
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$18.20 / $19.05 / $19.05
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $50.12 / $60.26
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $60.26 / $75.86
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.70 / $33.11 / $58.88