Child Prophylaxis (D1120) in California

Name: Child Prophylaxis (D1120) Reimbursement Rates in California — PayorMap
Creator: PayorMap
License: https://creativecommons.org/publicdomain/mark/1.0/
Keywords: child prophylaxis cost, child prophylaxis reimbursement rate, D1120 PPO rate, child prophylaxis negotiated rate, D1120 fee schedule, dental child prophylaxis price, D1120 dental insurance rate, dental cleaning cost

Negotiated reimbursement rates for D1120 from CMS Transparency in Coverage data. Based on 20 rate records from 20 providers in California.

Average Negotiated Rate in California

$50

20 rate records · 20 providers

📊 Data updated monthly · Last refresh: March 2026

Provider-Level Rates

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Individual provider rates for D1120 in California. 18 provider records.

Provider	City	Rate	Percentile
David HallOral Surgeon	Santa Barbara	$72	100th
Samantha JonesGeneral Dentist	Solvang	$72	100th
Amit ShahPediatric Dentist	Huntington Beach	$62	85th
Shohreh SelkiPediatric Dentist	Agoura Hills	$60	80th
Farangis PartoviPeriodontist	Rancho Palos Verdes	$60	80th
Hongsa SituEndodontist	Yorba Linda	$59	70th
Amir Shahab MohseniEndodontist	Laguna Hills	$53	65th
Shebli MehrazarinPeriodontist	Trabuco Canyon	$53	65th
Michael VongphoeGeneral Dentist	Rancho Cucamonga	$53	65th
Shahram MashadianOral & Maxillofacial Radiology	Victorville	$53	65th
Gulshan KumarGeneral Dentist	Brentwood	$49	45th
Todd BakerGeneral Dentist	Fullerton	$45	40th
Armine DerdiarianGeneral Dentist	Encino	$43	35th
Riska LimGeneral Dentist	Los Angeles	$42	30th
Robert LozanoGeneral Dentist	San Diego	$41	25th
Rashmi KumraGeneral Dentist	Walnut	$34	15th
Henry NguyenGeneral Dentist	Westminster	$22	10th
Christopher Taina LopezGeneral Dentist	Sunnyvale	$22	10th

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What is D1120?

Child Prophylaxis (CDT Code D1120) — These rates represent negotiated amounts between dental insurance payors and providers in California as reported in CMS Transparency in Coverage machine-readable files.

Top States for D1120

North Dakota

$74

1 records

Oregon

$69

3 records

New York

$69

6 records

36+ more states available with Pro ↓

Full Rate Breakdown

Median Rate

$53

Low

$22

High

$72

25th Percentile

$42

75th Percentile

$60

Data Points

Compare D1120 Rates Across All 39 States

North Dakota

$74

Oregon

$69

New York

$69

Nevada

$67

Washington

$63

Arizona

$61

New Jersey

$54

California

$50

Louisiana

$50

Georgia

$49

Texas

$48

Wisconsin

$47

South Carolina

$46

New Mexico

$46

Florida

$44

Puerto Rico

$44

Maryland

$40

Colorado

$39

Indiana

$38

Pennsylvania

$36

Connecticut

$36

Delaware

$36

Michigan

$35

Rhode Island

$34

Nebraska

$33

Kentucky

$32

Ohio

$32

Massachusetts

$31

Oklahoma

$31

Illinois

$31

North Carolina

$30

West Virginia

$30

Wyoming

$28

Minnesota

$26

Iowa

$22

Idaho

$22

Kansas

$22

Missouri

$22

Tennessee

$22

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