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Occlusal X-Ray

Wisconsin 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?

$17.78

Typical negotiated rate. In Wisconsin, July 2026.

Insurers have agreed to pay about $17.78 for this service. The price depends on where it is billed: about $17.78 from a physician practice, and about $15.49 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 8 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$17.78$13.18 to $33.11
FacilityA hospital or hospital-owned outpatient department$15.49$12.02 to $30.90

How much rates vary

Facilitymedian $15 · 10th to 90th $11 to $2,089Professionalmedian $18 · 10th to 90th $11 to $50
$10$50$200$1Kfacility $15professional $18

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
$11.48
Median
$11.48
Typical High
$11.48
Aetna
Setting
Professional
Modifier
Global
Typical Low
$11.22
Median
$12.59
Typical High
$14.79
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$15.14
Median
$23.44
Typical High
$51.29
DeanCare
Setting
Facility
Modifier
Global
Typical Low
$11.48
Median
$26.92
Typical High
$2,454.71
DeanCare
Setting
Professional
Modifier
Global
Typical Low
$10.47
Median
$10.47
Typical High
$10.47
Medica
Setting
Facility
Modifier
Global
Typical Low
$11.22
Median
$15.49
Typical High
$35.48
Medica
Setting
Professional
Modifier
Global
Typical Low
$281.84
Median
$281.84
Typical High
$281.84
Molina
Setting
Professional
Modifier
Global
Typical Low
$10.96
Median
$58.88
Typical High
$70.79
Prevea360
Setting
Facility
Modifier
Global
Typical Low
$11.22
Median
$13.80
Typical High
$28.18
Prevea360
Setting
Professional
Modifier
Global
Typical Low
$10.47
Median
$10.47
Typical High
$10.47
Quartz
Setting
Professional
Modifier
Global
Typical Low
$19.05
Median
$34.67
Typical High
$50.12
Quartz
Setting
Facility
Modifier
Global
Typical Low
$28.18
Median
$28.18
Typical High
$891.25
Quartz
Setting
Professional
Modifier
Global
Typical Low
$77.62
Median
$281.84
Typical High
$281.84
Security Health
Setting
Professional
Modifier
Global
Typical Low
$30.20
Median
$30.20
Typical High
$38.02

Where Wisconsin 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.

Wisconsin· 12th of 51

$17.78

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.