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Washington rates for HCPCS D4355

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

Facilitymedian $87 · 10th–90th $56–$1660%10%10th90th$87Professionalmedian $59 · 10th–90th $46–$1000%10%10th90th$59$50.0$200.0$1.0K$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
Facility
Modifier
Typical Low / Median / Typical High
$72.44 / $72.44 / $72.44
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $52.48 / $72.44
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $87.10 / $181.97
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $81.28 / $134.90
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $50.12 / $75.86
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$93.33 / $109.65 / $109.65
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $123.03 / $123.03