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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 October 2026.

How much does Limited Problem-Focused Oral Evaluation cost?

$28.18

Typical negotiated rate. In Pennsylvania, October 2026.

Insurers have agreed to pay about $28.18 for this service. The price depends on where it is billed: about $28.18 from a physician practice, and about $4,266 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 7 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$28.18$23.44 to $29.51
FacilityA hospital or hospital-owned outpatient department$4,266$22.39 to $5,012

How much rates vary

Facilitymedian $4,266 · 10th to 90th $22 to $56,234Professionalmedian $28 · 10th to 90th $21 to $30
$100$1K$10K$100Kfacility $4,266professional $28

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
$20.89
Median
$22.39
Typical High
$22.39
Aetna
Setting
Professional
Modifier
None
Typical Low
$20.89
Median
$22.39
Typical High
$27.54
Capital Blue Cross
Setting
Facility
Modifier
None
Typical Low
$4,265.80
Median
$5,011.87
Typical High
$79,432.82
Capital Blue Cross
Setting
Professional
Modifier
None
Typical Low
$28.18
Median
$28.18
Typical High
$29.51
Emblem Health
Setting
Professional
Modifier
None
Typical Low
$16.98
Median
$22.39
Typical High
$29.51
Geisinger
Setting
Professional
Modifier
None
Typical Low
$29.51
Median
$29.51
Typical High
$29.51
Martin's Point
Setting
Facility
Modifier
None
Typical Low
$22.39
Median
$22.39
Typical High
$22.39
Martin's Point
Setting
Professional
Modifier
None
Typical Low
$20.89
Median
$22.39
Typical High
$23.44
Oscar Health
Setting
Professional
Modifier
None
Typical Low
$25.70
Median
$25.70
Typical High
$57.54
United
Setting
Professional
Modifier
None
Typical Low
$10.96
Median
$43.65
Typical High
$60.26

Where Pennsylvania 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.

Pennsylvania· 35th of 51

$28.18

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.