go back

Ohio rates for HCPCS D0120

Periodic Oral Evaluation - Established Patient

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.97 / $15.97 / $71.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.29 / $15.97 / $19.87
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.00 / $29.50 / $41.32
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12,668.82 / $12,668.82 / $15,814.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.22 / $19.22 / $19.22
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.00 / $60.00 / $60.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.00 / $33.40 / $48.25