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Nebraska rates for HCPCS D4355

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

Facilitymedian $68 · 10th–90th $44–$1550%10%10th90th$68Professionalmedian $52 · 10th–90th $41–$740%20%10th90th$52$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
Facility
Modifier
Typical Low / Median / Typical High
$40.74 / $40.74 / $40.74
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $52.48 / $72.44
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,570.40 / $2,691.53 / $3,548.13
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $120.23 / $120.23
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$46.77 / $66.07 / $104.71
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
$81.28 / $102.33 / $131.83
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $104.71 / $131.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $102.33 / $128.82