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Utah rates for HCPCS D4341

Periodontal Scaling And Root Planing - Four Or More Teeth Per Quadrant

Facilitymedian $89 · 10th–90th $89–$890%50%100%$89Professionalmedian $100 · 10th–90th $89–$1410%20%40%10th90th$100$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$89.13 / $89.13 / $89.13
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $100.00 / $125.89
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $44.67 / $173.78
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $158.49 / $158.49
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $154.88 / $162.18