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Idaho rates for HCPCS D4355

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

Facilitymedian $68 · 10th–90th $50–$1150%10%20%10th90th$68Professionalmedian $56 · 10th–90th $46–$1000%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 / $52.48 / $72.44
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$204.17 / $562.34 / $831.76
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $117.49 / $123.03
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$50.12 / $66.07 / $112.20
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $56.23 / $72.44
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $2,754.23
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $104.71 / $177.83