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?
$25.70
Typical negotiated rate. In South Carolina, October 2026.
Insurers have agreed to pay about $25.70 for this service. The price depends on where it is billed: about $25.70 from a physician practice, and about $178 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 5 insurance carriers under federal price transparency rules.
Prices by location type
Billed by
Who charges it
Typical
Range
Physician practiceA doctor's office, clinic or independent provider
A doctor's office, clinic or independent provider
$25.70
$21.38 to $25.70
FacilityA hospital or hospital-owned outpatient department
A hospital or hospital-owned outpatient department
$178
$28.84 to $178
How much rates vary
Facilitymedian $178 · 10th to 90th $21 to $214Professionalmedian $26 · 10th to 90th $21 to $30
Distribution of negotiated rates across all payers (price axis is log-scale). 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
None
Typical Low
$21.38
Median
$21.38
Typical High
$21.38
Facility
None
$21.38
$21.38
$21.38
Aetna
Setting
Professional
Modifier
None
Typical Low
$21.38
Median
$21.38
Typical High
$25.12
Professional
None
$21.38
$21.38
$25.12
BCBS South Carolina
Setting
Facility
Modifier
None
Typical Low
$177.83
Median
$177.83
Typical High
$213.80
Facility
None
$177.83
$177.83
$213.80
BCBS South Carolina
Setting
Professional
Modifier
None
Typical Low
$25.70
Median
$25.70
Typical High
$25.70
Professional
None
$25.70
$25.70
$25.70
Medcost
Setting
Facility
Modifier
None
Typical Low
$21.38
Median
$25.12
Typical High
$27.54
Facility
None
$21.38
$25.12
$27.54
Medcost
Setting
Professional
Modifier
None
Typical Low
$25.70
Median
$26.92
Typical High
$34.67
Professional
None
$25.70
$26.92
$34.67
Molina
Setting
Professional
Modifier
None
Typical Low
$30.20
Median
$30.20
Typical High
$30.20
Professional
None
$30.20
$30.20
$30.20
United
Setting
Professional
Modifier
None
Typical Low
$41.69
Median
$45.71
Typical High
$61.66
Professional
None
$41.69
$45.71
$61.66
5 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
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.
Medcost
Setting
Professional
Modifier
51 · Multiple procedures
Typical Low
$12.88
Median
$13.18
Typical High
$19.50
Professional
51 · Multiple procedures
$12.88
$13.18
$19.50
Medcost
Setting
Professional
Modifier
80 · Assistant surgeon
Typical Low
$5.13
Median
$5.37
Typical High
$7.76
Professional
80 · Assistant surgeon
$5.13
$5.37
$7.76
Medcost
Setting
Professional
Modifier
81 · Minimal assistant surgeon
Typical Low
$3.63
Median
$3.72
Typical High
$5.50
Professional
81 · Minimal assistant surgeon
$3.63
$3.72
$5.50
Medcost
Setting
Professional
Modifier
82 · Assistant surgeon, no resident
Typical Low
$3.63
Median
$3.72
Typical High
$5.50
Professional
82 · Assistant surgeon, no resident
$3.63
$3.72
$5.50
Medcost
Setting
Professional
Modifier
AS · PA/NP assist
Typical Low
$3.63
Median
$3.72
Typical High
$5.50
Professional
AS · PA/NP assist
$3.63
$3.72
$5.50
Where South Carolina 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.