go back

Occlusal X-Ray

Pennsylvania rates for HCPCS D0240

An X-ray taken with the film or sensor placed flat on the biting surface of the upper or lower teeth, capturing a wider view of that section of the jaw than a standard single-tooth X-ray. It's often used to look at a broader area at once, such as locating an unerupted tooth, checking the roof or floor of the mouth, or examining young children who can't tolerate other X-ray placements as easily. It shows a different angle than the close-up, single-tooth style of image.

Rates data updated July 2026.

How much does Occlusal X-Ray cost?

$13.49

Typical negotiated rate. In Pennsylvania, July 2026.

Insurers have agreed to pay about $13.49 for this service. The price depends on where it is billed: about $13.49 from a physician practice, and about $13.80 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 5 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$13.49$12.02 to $14.13
FacilityA hospital or hospital-owned outpatient department$13.80$13.80 to $13.80

How much rates vary

Facilitymedian $14 · 10th to 90th $14 to $35Professionalmedian $13 · 10th to 90th $11 to $17
$10$100$1K$10Kfacility $14professional $13

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
$13.80
Median
$13.80
Typical High
$13.80
Aetna
Setting
Professional
Modifier
Global
Typical Low
$11.22
Median
$13.49
Typical High
$16.98
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$5,011.87
Median
$8,511.38
Typical High
$77,624.71
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$14.13
Median
$14.79
Typical High
$14.79
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$15.14
Median
$15.14
Typical High
$21.38
Highmark BCBS
Setting
Facility
Modifier
Global
Typical Low
$33.88
Median
$33.88
Typical High
$35.48
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$13.80
Median
$13.80
Typical High
$13.80
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$11.22
Median
$13.18
Typical High
$16.98

Where Pennsylvania sits

The same service costs 5.9 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· 41st of 51

$13.49

MN $66.07VT $11.22

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.