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Limited Problem-Focused Oral Evaluation

Illinois 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 October 2026.

How much does Limited Problem-Focused Oral Evaluation cost?

$18.20

Typical negotiated rate. In Illinois, October 2026.

Insurers have agreed to pay about $18.20 for this service. The price depends on where it is billed: about $18.20 from a physician practice, and about $191 from a hospital or other facility.

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 5 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$18.20$18.20 to $23.99
FacilityA hospital or hospital-owned outpatient department$191$170 to $191

How much rates vary

Facilitymedian $191 · 10th to 90th $20 to $229Professionalmedian $18 · 10th to 90th $18 to $29
$20$50$100$200facility $191professional $18

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$18.20
Median
$18.20
Typical High
$20.42
Aetna
Setting
Professional
Modifier
None
Typical Low
$18.20
Median
$18.20
Typical High
$28.18
BCBS Illinois
Setting
Facility
Modifier
None
Typical Low
$169.82
Median
$190.55
Typical High
$234.42
Hally Health
Setting
Professional
Modifier
None
Typical Low
$91.20
Median
$107.15
Typical High
$120.23
Hally Health
Setting
Facility
Modifier
None
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Molina
Setting
Professional
Modifier
None
Typical Low
$39.81
Median
$2,511.89
Typical High
$2,511.89
United
Setting
Professional
Modifier
None
Typical Low
$38.90
Median
$53.70
Typical High
$57.54

Where Illinois sits

The same service costs 5.1 times more in Minnesota than in West Virginia. 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.

Illinois· 50th of 51

$18.20

MN $85.11WV $16.60

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.