Cigna charge schedule
WebCIGNA DENTAL CARE PATIENT CHARGE SCHEDULE (K1I09) 92249.a - 4 - Patient Charge Code Procedure Description D0460 Pulp vitality tests $14.00 D0470 Diagnostic … WebCIGNA DENTAL CARE PATIENT CHARGE SCHEDULE (B1-09) 92249.a - 7 - Patient Charge Code Procedure Description D2941 Interim therapeutic restoration - Primary dentition $13.00 D2950 Core buildup – Including any pins $44.00 D2951 Pin retention – Per tooth – In addition to restoration $13.00
Cigna charge schedule
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WebPatient Charge Schedule Request. Use this form to request a CIGNA Dental Care patient charge schedule. Patient Charge Schedules are available to CIGNA Dental Care members only. If you have PPO or Traditional Indemnity coverage, please contact your employee relations office or your provider to obtain a benefit schedule. *Indicates required field. WebCIGNA DENTAL CARE PATIENT CHARGE SCHEDULE (Q5ZV0) 92260.a - 5 - Patient Charge Code Procedure Description Preventive resin restoration in a moderate to high caries risk 0% patient – Permanent tooth D1352 D1353 Sealant repair – Per tooth 0% D1354 Interim caries arresting medicament application 0%
WebThis Patient Charge Schedule applies only when covered alveolar services are performed by your Network Dentist, unless differently authorized by Cigna Dental. These codes (A5210, S5210, W9040 and A7350) are not allowed as other codes for option benefit, either at point of pre-authorisation real at claims payment; the fee for pain assistance is ... WebCigna Fee Schedule. We expect all accredited Cigna providers to abide by The Cigna Fee Schedule, the schedule contains fair and reasonable maximum fees for Surgery and Anaesthesia, as well as guideline fees for Initial and Follow up consultations. These fees are based on complexity, average duration of the procedure, information from our claims ...
WebCIGNA DENTAL CARE PATIENT CHARGE SCHEDULE (C06V9) 92255.a - 4 - Patient Charge Code Procedure Description Topical application of fluoride varnish (limit 2 per calendar year). $0.00 There is a combined limit of a total of 2 D1206s and/or D1208s per calendar year. D1206 WebCIGNA Dental Care® Patient Charge Schedule (DC-07) Code Procedure Description Patient Coinsurance Restorative (Fillings) D2140 Amalgam – 1 Surface, Primary or …
WebCIGNA DENTAL CARE® PLAN PATIENT CHARGE SCHEDULE Plan effective 1/1/2024 This Patient Charge Schedule lists the benefits of the Dental Plan including covered …
WebCigna Dental Care ® Patient Charge Schedule (P6XV0)-2-Code Procedure Description Patient Charge. Office Visit Fee (Per patient, per office visit in addition to any other … graphic tiersWebCIGNA DENTAL CARE PATIENT CHARGE SCHEDULE (K1-09) 92249.a - 4 - Patient Charge Code Procedure Description Additional prophylaxis (cleaning) – In addition to the 2 $30.00 prophylaxes (cleanings) allowed per calendar year Topical application of fluoride varnish (limit 2 per calendar year). $0.00 chiropractor xlWebcigna dental care® patient cHarge scHedule Code Procedure Description Patient Charge D0170 Reevaluation – Limited, problem focused (not postoperative visit) $0.00 D0180 … chiropractor wyalusing paWebThis Patient Charge Schedule applies only when covered alveolar services are performed by your Network Dentist, unless differently authorized by Cigna Dental. These codes … graphic tie dye t shirtsWeb• Cigna Dental considers infection control and/or sterilization to be incidental to and part of the charges for services provided and not separately chargeable. 92249 856609 02/13 L1-09 L1-09 cigna dental care® (*dHMO) patient cHarge scHedule This Patient Charge Schedule lists the benefits of the Dental Plan including chiropractor wyandotte michiganWebCIGNA DENTAL CARE PATIENT CHARGE SCHEDULE (P5X00) 92256.a - 5 - Patient Charge Code Procedure Description Preventive resin restoration in a moderate to high caries risk $10.00 patient – Permanent tooth D1352 D1353 Sealant repair – Per tooth $7.00 D1354 Interim caries arresting medicament application $0.00 chiropractor wylieWebCIGNA DENTAL CARE PATIENT CHARGE SCHEDULE (G1-09) 92249.a - 4 - Patient Charge Code Procedure Description Additional prophylaxis (cleaning) – In addition to … chiropractor yankalilla