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Kentucky rates for HCPCS D4355

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$53.34 / $53.34 / $53.34
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.28 / $53.34 / $68.52
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$82.50 / $101.00 / $101.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$73.31 / $73.31 / $73.31
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.00 / $45.00 / $3,000.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$86.00 / $96.00 / $113.00