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Occlusal X-Ray

South Dakota 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?

$14.79

Typical negotiated rate. In South Dakota, July 2026.

Insurers have agreed to pay about $14.79 for this service. Most negotiated rates run $14.45 to $21.38.

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 4 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $23 · 10th to 90th $16 to $29Professionalmedian $15 · 10th to 90th $14 to $30
$20$50$100$200facility $23professional $15

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. 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
Global
Typical Low
$16.22
Median
$16.22
Typical High
$16.22
Aetna
Setting
Professional
Modifier
Global
Typical Low
$14.45
Median
$14.45
Typical High
$14.79
Medica
Setting
Facility
Modifier
Global
Typical Low
$19.05
Median
$24.55
Typical High
$28.84
Medica
Setting
Professional
Modifier
Global
Typical Low
$14.13
Median
$25.12
Typical High
$281.84
Midlands
Setting
Professional
Modifier
Global
Typical Low
$21.38
Median
$25.12
Typical High
$33.88
Midlands
Setting
Professional
Modifier
Global
Typical Low
$27.54
Median
$27.54
Typical High
$27.54
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$30.20
Median
$30.20
Typical High
$30.20

Where South Dakota 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.

South Dakota· 20th of 51

$14.79

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.