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Limited Problem-Focused Oral Evaluation

Pennsylvania 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?

$23.44

Typical negotiated rate. In Pennsylvania, July 2026.

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

How much rates vary

Facilitymedian $21 · 10th to 90th $21 to $22Professionalmedian $23 · 10th to 90th $20 to $34
$100$1K$10Kfacility $21professional $23

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
$20.89
Median
$20.89
Typical High
$22.39
Aetna
Setting
Professional
Modifier
Global
Typical Low
$20.42
Median
$23.44
Typical High
$33.88
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$8,511.38
Median
$8,511.38
Typical High
$77,624.71
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$28.18
Median
$29.51
Typical High
$29.51
Emblem Health
Setting
Facility
Modifier
Global
Typical Low
$32.36
Median
$32.36
Typical High
$32.36
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$16.98
Median
$22.39
Typical High
$29.51
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$29.51
Median
$29.51
Typical High
$29.51
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$20.89
Median
$20.89
Typical High
$20.89
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$20.42
Median
$23.99
Typical High
$38.90
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$16.98
Median
$25.70
Typical High
$25.70
United
Setting
Professional
Modifier
Global
Typical Low
$10.96
Median
$42.66
Typical High
$61.66

Where Pennsylvania 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.

Pennsylvania· 49th of 51

$23.44

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.