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Utah rates for HCPCS D4341

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$89.13 / $89.13 / $89.13
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.11 / $97.72 / $107.15
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $44.67 / $173.78
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$151.36 / $158.49 / $158.49
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.83 / $147.91 / $162.18