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?
$25.12
Typical physician fee. In New Jersey, July 2026.
Insurers have agreed to pay about $25.12 for this service. Most negotiated rates run $21.38 to $28.84.
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 3 insurance carriers under federal price transparency rules.
How much rates vary
Facilitymedian $29 · 10th to 90th $28 to $1,288Professionalmedian $25 · 10th to 90th $20 to $33
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
Facility/Professional
Modifier
Typical LowTypical Low is the 10th percentile of the published rates, Median the 50th, and Typical High the 90th. One in ten rates falls below Typical Low, and one in ten falls above Typical High.
MedianTypical Low is the 10th percentile of the published rates, Median the 50th, and Typical High the 90th. One in ten rates falls below Typical Low, and one in ten falls above Typical High.
Typical HighTypical Low is the 10th percentile of the published rates, Median the 50th, and Typical High the 90th. One in ten rates falls below Typical Low, and one in ten falls above Typical High.
Aetna
Setting
Facility
Modifier
Global
Typical Low
$27.54
Median
$28.84
Typical High
$1,288.25
Facility
Global
$27.54
$28.84
$1,288.25
Aetna
Setting
Professional
Modifier
Global
Typical Low
$20.42
Median
$25.12
Typical High
$33.11
Professional
Global
$20.42
$25.12
$33.11
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$15.49
Median
$22.39
Typical High
$32.36
Professional
Global
$15.49
$22.39
$32.36
United
Setting
Professional
Modifier
Global
Typical Low
$37.15
Median
$52.48
Typical High
$79.43
Professional
Global
$37.15
$52.48
$79.43
Where New Jersey 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.