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Iowa rates for HCPCS D4355

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

Facilitymedian $63 · 10th–90th $44–$1260%20%10th90th$63Professionalmedian $52 · 10th–90th $43–$910%20%10th90th$52$50.0$100.0$200.0$500.0$1.0K

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
Facility
Modifier
Typical Low / Median / Typical High
$51.29 / $51.29 / $51.29
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $52.48 / $72.44
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $194.98 / $208.93
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$43.65 / $63.10 / $125.89
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $371.54 / $371.54
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $112.20 / $173.78
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $131.83 / $173.78
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $104.71
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $144.54 / $144.54