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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 October 2026.

How much does Limited Problem-Focused Oral Evaluation cost?

$30.90

Typical negotiated rate. In New York, October 2026.

Insurers have agreed to pay about $30.90 for this service. The price depends on where it is billed: about $30.90 from a physician practice, and about $23.44 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 8 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$30.90$27.54 to $34.67
FacilityA hospital or hospital-owned outpatient department$23.44$20.42 to $28.18

How much rates vary

Facilitymedian $23 · 10th to 90th $15 to $52Professionalmedian $31 · 10th to 90th $23 to $36
$20$50facility $23professional $31

Distribution of negotiated rates across all payers (price axis is log-scale). 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
None
Typical Low
$19.05
Median
$19.50
Typical High
$27.54
Aetna
Setting
Professional
Modifier
None
Typical Low
$19.05
Median
$19.95
Typical High
$25.12
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$27.54
Median
$32.36
Typical High
$36.31
Emblem Health
Setting
Facility
Modifier
None
Typical Low
$15.49
Median
$25.70
Typical High
$56.23
Emblem Health
Setting
Professional
Modifier
None
Typical Low
$16.98
Median
$16.98
Typical High
$26.92
Excellus BCBS
Setting
Professional
Modifier
None
Typical Low
$23.44
Median
$56.23
Typical High
$56.23
Highmark BCBS
Setting
Facility
Modifier
None
Typical Low
$79.43
Median
$79.43
Typical High
$79.43
MVP Health Care
Setting
Professional
Modifier
None
Typical Low
$28.18
Median
$30.90
Typical High
$46.77
United
Setting
Professional
Modifier
None
Typical Low
$37.15
Median
$48.98
Typical High
$61.66
Univera
Setting
Facility
Modifier
None
Typical Low
$22.91
Median
$22.91
Typical High
$23.44
Univera
Setting
Professional
Modifier
None
Typical Low
$14.13
Median
$23.44
Typical High
$56.23

Where New York 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.

New York· 31st of 51

$30.90

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.