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South Dakota rates for HCPCS D0120

Periodic Oral Evaluation - Established Patient

Facilitymedian $17 · 10th–90th $16–$300%50%10th90th$17Professionalmedian $16 · 10th–90th $13–$440%20%10th90th$16$10.0$20.0$50.0$100.0

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
$15.85 / $15.85 / $15.85
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.88 / $15.85 / $43.65
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$13.49 / $22.39 / $33.11
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.22 / $109.65 / $109.65
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$24.55 / $28.18 / $39.81
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $32.36 / $38.90
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $40.74 / $40.74