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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 October 2026.

How much does Limited Problem-Focused Oral Evaluation cost?

$81.28

Typical negotiated rate. In Massachusetts, October 2026.

Insurers have agreed to pay about $81.28 for this service. The price depends on where it is billed: about $81.28 from a physician practice, and about $39.81 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 6 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$81.28$42.66 to $158
FacilityA hospital or hospital-owned outpatient department$39.81$33.88 to $57.54

How much rates vary

Facilitymedian $40 · 10th to 90th $34 to $126Professionalmedian $81 · 10th to 90th $36 to $158
$20$100$500$2Kfacility $40professional $81

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
$38.90
Median
$38.90
Typical High
$38.90
Aetna
Setting
Professional
Modifier
None
Typical Low
$30.20
Median
$38.90
Typical High
$50.12
AllWays Health Partners
Setting
Facility
Modifier
None
Typical Low
$25.70
Median
$66.07
Typical High
$125.89
AllWays Health Partners
Setting
Professional
Modifier
None
Typical Low
$33.11
Median
$87.10
Typical High
$158.49
Fallon Health
Setting
Facility
Modifier
None
Typical Low
$33.88
Median
$39.81
Typical High
$64.57
Fallon Health
Setting
Professional
Modifier
None
Typical Low
$33.88
Median
$36.31
Typical High
$39.81
Harvard Pilgrim
Setting
Professional
Modifier
None
Typical Low
$47.86
Median
$95.50
Typical High
$114.82
Mass General Brigham
Setting
Facility
Modifier
None
Typical Low
$25.70
Median
$66.07
Typical High
$125.89
Mass General Brigham
Setting
Professional
Modifier
None
Typical Low
$33.11
Median
$87.10
Typical High
$158.49
United
Setting
Professional
Modifier
None
Typical Low
$39.81
Median
$44.67
Typical High
$64.57

Where Massachusetts 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.

Massachusetts· 2nd of 51

$81.28

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.