go back

Limited Problem-Focused Oral Evaluation

New York 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?

$28.84

Typical negotiated rate. In New York, July 2026.

Insurers have agreed to pay about $28.84 for this service. The price depends on where it is billed: about $29.51 from a physician practice, and about $19.05 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$29.51$23.44 to $34.67
FacilityA hospital or hospital-owned outpatient department$19.05$19.05 to $20.89

How much rates vary

Facilitymedian $19 · 10th to 90th $19 to $21Professionalmedian $30 · 10th to 90th $20 to $39
$20$50$100facility $19professional $30

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
$19.05
Median
$19.05
Typical High
$20.89
Aetna
Setting
Professional
Modifier
Global
Typical Low
$19.05
Median
$23.99
Typical High
$38.90
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$27.54
Median
$32.36
Typical High
$40.74
Emblem Health
Setting
Facility
Modifier
Global
Typical Low
$20.42
Median
$25.70
Typical High
$39.81
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$15.49
Median
$21.38
Typical High
$30.90
Excellus BCBS
Setting
Professional
Modifier
Global
Typical Low
$14.13
Median
$53.70
Typical High
$53.70
MVP Health Care
Setting
Professional
Modifier
Global
Typical Low
$28.18
Median
$30.90
Typical High
$42.66
United
Setting
Professional
Modifier
Global
Typical Low
$37.15
Median
$51.29
Typical High
$61.66
Univera
Setting
Facility
Modifier
Global
Typical Low
$19.95
Median
$23.44
Typical High
$25.12
Univera
Setting
Professional
Modifier
Global
Typical Low
$19.95
Median
$23.44
Typical High
$53.70

Where New York 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.

New York· 17th of 51

$28.84

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.