Office Fees
A Service Fee Overview
Preventative Care
Cost
Dental Code
Cost with Triple Crown Savings Program
Oral Exam
$69 - $101
(D0120) (D0140) (D0145)
$55 - $73
Digital X-rays
$37 - $151
$30 - $121
Comprensive Oral Exams
$120 - $193
(D0150) (D0160)
$96 - $154
Comprehensive Periodontal Exam
$129
(D0180)
$103
Amalgam Filings
$186 - $343
(D2140) (D2150) (D2160) (D2161)
$149 - $274
Composite Fillings
$217 - $433
(D2330) (D2331) (D2332) (D2335) (D2390) (D2391) (D2392) (D2393) (D2394) (D2395)
$174 - $346
Scaling and Root Planing
$250 - $333
(D4341) (D4342)
$200 - $266
Arestin Antimicrobial Treatment
$158
(D4381)
$126
Restorative Dental Services
Cost
Dental Code
Cost with Triple Crown Savings Program
Dental Implants
$1,590 - $9,073
(D6010) (D6011) (D6013) (D6040) (D6050)
$1,272 - $7,258
Implant Supported Crowns
$1,873 - $1.947
$1,498 - $1,578
Porcelain/Ceramic Crowns
$1,416 - $1,495
(D2740) (D2790)
$1,014 - $1,100
Tooth Extraction
$173 - $750
(D7111) (D7140) (D7210) (D7220) (D7241) ( (D7230) (D7240)
$138 - $480
Root Canal Treatment
$945 - $1,320
(D3310)(D3320) (D3330)
$756 - $1,056
Clear Aligners
$5,999
(D8090)
$4,799
Sleep Apnea Custom Appliance
$379
(D9947)
$303
Dental Bone Grafting
$721 - $861
(D4263) (D4264)
$577 - $689
Cosmetic Dental Services
Cost
Dental Code
Cost with Triple Crown Savings Program
Teeth Whitening Trays
$120
(D9975)
$96
In-Office Teeth Whitening
$432
(D9972)
$346
Dental Veneers
$869 - $1,488 (Per Tooth)
(D2960) (D2962)
$695 - $1,190
Dental Inlays and Onlays
$960 - $1,291
$922 - $1,011
Removable Prosthetics
Cost
Dental Code
Cost with Triple Crown Savings Program
Complete Denture
$2,284 - $2,405
(D5110) (D5120) (D5130) (D5140)
$1,827 - $1,924
Partial Denture
$1,460 - $2,353
$1,226 - $1.882
Additional Dental Services
Cost
Dental Code
Cost with Triple Crown Savings Program
IV Sedation
$305 - $317
(D9223) (D9243) (D9222) (D9239)
$244 - $254
