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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 July 2026.

How much does Limited Problem-Focused Oral Evaluation cost?

$24.55

Typical negotiated rate. In Illinois, July 2026.

Insurers have agreed to pay about $24.55 for this service. The price depends on where it is billed: about $24.55 from a physician practice, and about $170 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 5 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$24.55$20.89 to $30.20
FacilityA hospital or hospital-owned outpatient department$170$170 to $209

How much rates vary

Facilitymedian $170 · 10th to 90th $20 to $275Professionalmedian $25 · 10th to 90th $19 to $68
$20$50$100$200facility $170professional $25

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. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$20.42
Median
$20.42
Typical High
$20.42
Aetna
Setting
Professional
Modifier
Global
Typical Low
$18.62
Median
$23.44
Typical High
$33.11
BCBS
Setting
Facility
Modifier
Global
Typical Low
$169.82
Median
$199.53
Typical High
$275.42
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$91.20
Median
$107.15
Typical High
$120.23
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Molina
Setting
Professional
Modifier
Global
Typical Low
$39.81
Median
$2,511.89
Typical High
$2,511.89
United
Setting
Professional
Modifier
Global
Typical Low
$50.12
Median
$70.79
Typical High
$104.71

Where Illinois 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.

Illinois· 44th of 51

$24.55

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.