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Limited Problem-Focused Oral Evaluation

California rates for HCPCS D0140

A focused examination centered on a specific complaint, such as pain, swelling, or an injury, rather than a full review of the entire mouth. The dentist evaluates the problem area and may take a targeted X-ray to figure out what is going on, often on a same-day or urgent basis. It is not a substitute for a routine or comprehensive check-up.

Rates data updated July 2026.

How much does Limited Problem-Focused Oral Evaluation cost?

$30.20

Typical negotiated rate. In California, July 2026.

Insurers have agreed to pay about $30.20 for this service. The price depends on where it is billed: about $30.20 from a physician practice, and about $31.62 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 9 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$30.20$23.99 to $35.48
FacilityA hospital or hospital-owned outpatient department$31.62$25.70 to $38.90

How much rates vary

Facilitymedian $32 · 10th to 90th $21 to $58Professionalmedian $30 · 10th to 90th $20 to $52
$20$50$100$200facility $32professional $30

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$28.84
Median
$28.84
Typical High
$28.84
Aetna
Setting
Professional
Modifier
Global
Typical Low
$20.42
Median
$28.84
Typical High
$35.48
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$26.92
Median
$38.90
Typical High
$47.86
Blue Shield
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$39.81
Typical High
$74.13
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$398.11
Typical High
$831.76
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$158.49
Median
$158.49
Typical High
$158.49
Lucent Health
Setting
Professional
Modifier
Global
Typical Low
$158.49
Median
$199.53
Typical High
$199.53
Molina
Setting
Professional
Modifier
Global
Typical Low
$30.90
Median
$30.90
Typical High
$724.44
Optum
Setting
Professional
Modifier
Global
Typical Low
$54.95
Median
$54.95
Typical High
$70.79
Providence
Setting
Facility
Modifier
Global
Typical Low
$21.38
Median
$30.90
Typical High
$46.77
Providence
Setting
Professional
Modifier
Global
Typical Low
$28.18
Median
$60.26
Typical High
$85.11
United
Setting
Professional
Modifier
Global
Typical Low
$37.15
Median
$46.77
Typical High
$67.61

Where California sits

The same service costs 4.6 times more in Minnesota than in Vermont. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

California· 9th of 51

$30.20

MN $102VT $22.39

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.