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Pennsylvania rates for HCPCS D0140

Limited Oral Evaluation - Problem Focused

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.74 / $1,458.80 / $1,458.80
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.22 / $23.88 / $33.58
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,459.92 / $8,639.91 / $79,506.39
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.19 / $29.25 / $29.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.29 / $32.29 / $32.29
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$32.65 / $32.65 / $32.65
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.32 / $21.05 / $33.74
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.74 / $20.74 / $1,458.80
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.73 / $28.57 / $48.40
Oscar Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.00 / $26.00 / $26.00
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.00 / $26.00 / $28.50
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.29 / $32.29 / $32.29
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.00 / $46.00 / $61.00