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Tennessee rates for HCPCS D0120

Periodic Oral Evaluation - Established Patient

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.35 / $15.30 / $19.64
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.25 / $35.00 / $82.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.22 / $19.22 / $19.22
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$32.09 / $86.18 / $86.18
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$108.59 / $108.59 / $139.05