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Full Mouth Debridement

South Carolina rates for HCPCS D4355

Removal of heavy plaque and tartar buildup across the entire mouth when deposits are so extensive that the dentist cannot properly see the teeth and gums to complete an exam. It is a preliminary cleaning step, done before a comprehensive evaluation or treatment planning can happen, rather than a routine cleaning. A separate cleaning or gum treatment is typically still needed afterward.

Rates data updated October 2026.

How much does Full Mouth Debridement cost?

$48.98

Typical negotiated rate. In South Carolina, October 2026.

Insurers have agreed to pay about $48.98 for this service. The price depends on where it is billed: about $48.98 from a physician practice, and about $1,950 from a hospital or other facility.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 5 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$48.98$48.98 to $58.88
FacilityA hospital or hospital-owned outpatient department$1,950$1,445 to $3,631

How much rates vary

Facilitymedian $1,950 · 10th to 90th $89 to $4,266Professionalmedian $49 · 10th to 90th $49 to $66
$50$100$200$500$1K$2K$5Kfacility $1,950professional $49

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$48.98
Median
$48.98
Typical High
$48.98
Aetna
Setting
Professional
Modifier
None
Typical Low
$48.98
Median
$48.98
Typical High
$57.54
BCBS South Carolina
Setting
Facility
Modifier
None
Typical Low
$1,445.44
Median
$2,290.87
Typical High
$4,265.80
Medcost
Setting
Facility
Modifier
None
Typical Low
$48.98
Median
$57.54
Typical High
$63.10
Medcost
Setting
Professional
Modifier
None
Typical Low
$58.88
Median
$58.88
Typical High
$77.62
Medcost
Setting
Professional
Modifier
51 · Multiple procedures
Typical Low
$28.84
Median
$29.51
Typical High
$43.65
Molina
Setting
Professional
Modifier
None
Typical Low
$30.20
Median
$30.20
Typical High
$54.95
United
Setting
Professional
Modifier
None
Typical Low
$69.18
Median
$81.28
Typical High
$123.03

Where South Carolina sits

The same service costs 9.5 times more in Texas than in West Virginia. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

South Carolina· 48th of 51

$48.98

TX $372WV $38.90

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.