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Texas rates for HCPCS D4355

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

Facilitymedian $69 · 10th–90th $48$1260%20%10th90th$69Professionalmedian $52 · 10th–90th $43$740%20%40%10th90th$52$1.0$5.0$20.0$100.0$500.0$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
Facility
Modifier
Typical Low / Median / Typical High
$45.71 / $51.29 / $51.29
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$42.66 / $52.48 / $72.44
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $89.13 / $89.13
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $79.43 / $79.43
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$891.25 / $891.25 / $891.25
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$371.54 / $478.63 / $478.63
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$47.86 / $69.18 / $107.15
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$42.66 / $52.48 / $72.44
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $30.20
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $0.60 / $0.60
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$47.86 / $69.18 / $107.15
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $79.43 / $91.20
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $39.81 / $54.95
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $79.43 / $104.71