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South Dakota rates for HCPCS D4355

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

Facilitymedian $54 · 10th–90th $52–$1050%20%40%10th90th$54Professionalmedian $52 · 10th–90th $46–$680%20%40%10th90th$52$50.0$100.0$200.0

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
$52.48 / $52.48 / $52.48
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $52.48 / $67.61
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$43.65 / $81.28 / $112.20
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $371.54 / $371.54
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $102.33 / $125.89
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $144.54
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $144.54 / $144.54