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Virginia rates for HCPCS D4355

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

Facilitymedian $69 · 10th–90th $50–$1120%10%10th90th$69Professionalmedian $65 · 10th–90th $46–$1050%10%10th90th$65$10.0$50.0$200.0$1.0K

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
$74.13 / $74.13 / $74.13
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $52.48 / $74.13
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $83.18 / $138.04
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $107.15 / $190.55
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $63.10 / $109.65
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$50.12 / $69.18 / $112.20
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $46.77 / $63.10
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$53.70 / $67.61 / $117.49
Sentara
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $67.61 / $117.49
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $77.62 / $177.83