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New York rates for HCPCS D4355

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

Facilitymedian $47 · 10th–90th $43–$550%20%40%10th90th$47Professionalmedian $66 · 10th–90th $46–$830%10%10th90th$66$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
$42.66 / $46.77 / $46.77
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$42.66 / $52.48 / $75.86
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $74.13 / $87.10
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,348.96 / $1,348.96 / $4,073.80
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $53.70 / $53.70
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $74.13 / $100.00
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $104.71 / $141.25
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$45.71 / $53.70 / $54.95
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $53.70 / $58.88