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Alaska rates for HCPCS D4355

Full Mouth Debridement To Enable A Comprehensive Periodontal Evaluation And Diagnosis On A Subsequent Visit

Facilitymedian $74 · 10th–90th $50–$1260%10%10th90th$74Professionalmedian $56 · 10th–90th $46–$720%10%20%10th90th$56$50.0$100.0$200.0$500.0$1.0K$2.0K

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
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $56.23 / $72.44
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$50.12 / $74.13 / $125.89
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $57.54 / $79.43
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,467.37 / $3,467.37 / $3,467.37
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $257.04 / $263.03
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$50.12 / $74.13 / $125.89
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $79.43 / $91.20