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New Jersey 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
$36.32 / $36.32 / $753.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.32 / $53.57 / $73.09
Horizon BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,262.04 / $3,262.04 / $4,042.19
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.75 / $67.94 / $69.98
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.00 / $108.00 / $158.00