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Oklahoma rates for HCPCS D4355

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.20 / $48.29 / $68.19
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.00 / $72.00 / $72.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47.73 / $51.16 / $91.84
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.14 / $102.73 / $367.45