| Sample Dental Procedure * |
National Fees As High as*
|
Plan Fees
|
Plan Savings
|
| Initial Oral Exam |
$ 90
|
$ 15
|
83%
|
| Periodic Oral Exam |
$ 40
|
$ 5
|
88%
|
| X-Rays |
| Intraoral Complete Series |
$ 90
|
$ 15
|
83%
|
| Panoramic |
$ 75
|
$ 15
|
80%
|
| Regular Teeth Cleaning |
|
|
|
|
(Light Scaling & Polishing)
|
$ 65
|
$ 15
|
77%
|
| Deep Teeth Cleaning |
| (Full Mouth Debridement)Removal of heavy tarter buildup) |
$ 120
|
$ 55 |
54%
|
| Amalgam Filling (Silver Colored) |
|
|
|
|
1 Surface
|
$ 85
|
$ 20
|
77%
|
|
2 Surfaces
|
$ 104
|
$ 35
|
66%
|
| Composite Filling (Tooth Colored) |
| 1 Surface (Anterior) |
$ 110
|
$ 35
|
68%
|
| 2 Surfaces (Anterior) |
$ 135
|
$ 55
|
59%
|
| Sedative Filling (Temporary) |
$ 75
|
$ 20
|
73%
|
| Simple Extraction |
$ 100
|
$ 35
|
65%
|
| Root Canal |
|
Anterior
|
$ 450
|
$ 195
|
57%
|
|
Bicuspid
|
$ 525
|
$ 250
|
52%
|
| Porcelain Crown |
|
|
|
|
w/High Noble Metal
|
$ 800
|
$ 395
|
51%
|
| Complete Dentures |
|
|
|
|
Upper or Lower
|
$ 1100
|
$ 450
|
59%
|
Orthodontic Treatment (Braces)
by General Dentist |
|
| Children (under Age 19) |
$ 3850
|
$ 1850
|
52%
|
| Adults (19 and Over) |
$ 4100
|
$ 1950
|
53%
|
| |
* American Dental Association (ADA) 1995 National Survey of Dental Fees Dental Economics, Annual Dental
Fee Survey, 1996 Published May, 1997
|
