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Minnesota 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
$52.48 / $52.48 / $52.48
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.66 / $52.48 / $72.44
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$31.62 / $302.00 / $7,585.78
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$177.83 / $218.78 / $218.78
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47.86 / $64.57 / $104.71
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$371.54 / $371.54 / $371.54