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Oregon rates for HCPCS D4355

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

Facilitymedian $102 · 10th–90th $56–$1120%20%40%10th90th$102Professionalmedian $56 · 10th–90th $46–$760%10%20%10th90th$56$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
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $53.70 / $72.44
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $117.49 / $141.25
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$50.12 / $74.13 / $125.89
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $56.23 / $74.13
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$93.33 / $109.65 / $109.65
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$50.12 / $74.13 / $123.03
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $79.43 / $141.25