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South Carolina rates for HCPCS D4355

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

Facilitymedian $68 · 10th–90th $49$1170%10%10th90th$68Professionalmedian $52 · 10th–90th $45$720%20%10th90th$52$50.0$100.0$200.0$500.0$1.0K$2.0K$5.0K

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
$44.67 / $52.48 / $72.44
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$831.76 / $1,819.70 / $3,981.07
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$48.98 / $66.07 / $107.15
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $54.95
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $81.28 / $123.03