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South Carolina rates for HCPCS D0120

Periodic Oral Evaluation - Established Patient

Facilitymedian $19 · 10th–90th $15–$300%10%10th90th$19Professionalmedian $15 · 10th–90th $12–$190%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
Professional
Modifier
Typical Low / Median / Typical High
$12.02 / $15.14 / $19.05
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$134.90 / $186.21 / $354.81
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.44 / $26.30 / $33.88
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$14.79 / $18.62 / $29.51
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $54.95 / $54.95
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.92 / $34.67 / $41.69