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Occlusal X-Ray

Utah 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?

$14.13

Typical negotiated rate. In Utah, July 2026.

Insurers have agreed to pay about $14.13 for this service. Most negotiated rates run $13.18 to $14.79.

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 $14 · 10th to 90th $14 to $14Professionalmedian $14 · 10th to 90th $12 to $20
$20$50facility $14professional $14

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
$14.13
Median
$14.13
Typical High
$14.13
Aetna
Setting
Professional
Modifier
Global
Typical Low
$12.02
Median
$13.18
Typical High
$14.79
Molina
Setting
Professional
Modifier
Global
Typical Low
$25.12
Median
$44.67
Typical High
$60.26
Select Health
Setting
Facility
Modifier
Global
Typical Low
$20.42
Median
$20.42
Typical High
$20.42
Select Health
Setting
Professional
Modifier
Global
Typical Low
$19.95
Median
$20.42
Typical High
$20.89
U of Utah Health Plan
Setting
Professional
Modifier
Global
Typical Low
$16.98
Median
$19.05
Typical High
$20.89

Where Utah 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.

Utah· 24th of 51

$14.13

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.