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Limited Problem-Focused Oral Evaluation

Massachusetts 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?

$38.90

Typical negotiated rate. In Massachusetts, July 2026.

Insurers have agreed to pay about $38.90 for this service. The price depends on where it is billed: about $38.90 from a physician practice, and about $38.90 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 7 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$38.90$23.99 to $67.61
FacilityA hospital or hospital-owned outpatient department$38.90$38.90 to $105

How much rates vary

Facilitymedian $39 · 10th to 90th $22 to $158Professionalmedian $39 · 10th to 90th $20 to $100
$20$50$100$200facility $39professional $39

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
$38.90
Median
$38.90
Typical High
$38.90
Aetna
Setting
Professional
Modifier
Global
Typical Low
$20.42
Median
$25.12
Typical High
$43.65
AllWays Health Partners
Setting
Facility
Modifier
Global
Typical Low
$20.89
Median
$141.25
Typical High
$158.49
AllWays Health Partners
Setting
Professional
Modifier
Global
Typical Low
$26.30
Median
$64.57
Typical High
$158.49
Cigna
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$32.36
Typical High
$32.36
Fallon Health
Setting
Facility
Modifier
Global
Typical Low
$36.31
Median
$46.77
Typical High
$87.10
Fallon Health
Setting
Professional
Modifier
Global
Typical Low
$33.11
Median
$36.31
Typical High
$38.90
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$40.74
Median
$74.13
Typical High
$107.15
Mass General Brigham
Setting
Facility
Modifier
Global
Typical Low
$20.89
Median
$141.25
Typical High
$158.49
Mass General Brigham
Setting
Professional
Modifier
Global
Typical Low
$26.30
Median
$64.57
Typical High
$158.49
United
Setting
Professional
Modifier
Global
Typical Low
$39.81
Median
$44.67
Typical High
$64.57

Where Massachusetts 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.

Massachusetts· 5th of 51

$38.90

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.