OneSmile Dental Plan

OneSmile Dental Plan
FREE Exams	IMMEDIATE plan activation
FREE X-Rays	NO annual maximums
LOW yearly membership fee	NO claim forms to submit
GUARANTEED acceptance	LARGE selection of participating offices

Sample of Savings may not be applicable to your state. Please select your state to view your Sample of Savings.

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20%-40%
SAVINGS

20%-40% off all dental services including, Cosmetic and Specialty such as periodontics, oral surgery, endodontics, orthodontics and pedodontics.

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Procedure	UCR - Cost without the plan*	Cost with the Plan	Your Savings
Comprehensive Exam	$93	No Charge	$93
Full Mouth X-rays	$141	No Charge	$141
Oral Evaluation - Periodic	$58	No Charge	$58
Prophylaxis (Cleaning) - Adult	$102	$69	$33
Filling - 2 Surfaces	$251	$180	$71
Crown - Porcelain/Ceramic	$1,296	$904	$392
Core Buildup - (Including Any Pins)	$286	$179	$107
Extraction – Erupted Tooth	$188	$123	$65
Total Cost With Plan	$2,415	$1,455	$960
Comprehensive Exam	$80	No Charge	$80
Full Mouth X-rays	$136	No Charge	$136
Oral Evaluation - Periodic	$49	No Charge	$49
Prophylaxis (Cleaning) - Adult	$88	$69	$19
Filling - 2 Surfaces	$225	$180	$45
Crown - Porcelain/Ceramic	$1,170	$904	$266
Core Buildup - (Including Any Pins)	$252	$179	$73
Extraction – Erupted Tooth	$154	$123	$31
Total Cost With Plan	$2,154	$1,455	$699
Comprehensive Exam	$124	No Charge	$124
Full Mouth X-rays	$186	No Charge	$186
Oral Evaluation - Periodic	$77	No Charge	$77
Prophylaxis (Cleaning) - Adult	$138	$69	$69
Filling - 2 Surfaces	$316	$190	$126
Crown - Porcelain/Ceramic	$1,480	$949	$531
Core Buildup - (Including Any Pins)	$326	$199	$127
Extraction – Erupted Tooth	$219	$125	$94
Total Cost With Plan	$2,866	$1,532	$1,334
Comprehensive Exam	$124	No Charge	$124
Full Mouth X-rays	$186	No Charge	$186
Oral Evaluation - Periodic	$77	No Charge	$77
Prophylaxis (Cleaning) - Adult	$138	$87	$51
Filling - 2 Surfaces	$316	$253	$63
Crown - Porcelain/Ceramic	$1,480	$1,036	$444
Core Buildup - (Including Any Pins)	$326	$261	$65
Extraction – Erupted Tooth	$219	$175	$44
Total Cost With Plan	$2,866	$1,812	$1,054
Comprehensive Exam	$124	No Charge	$124
Full Mouth X-rays	$186	No Charge	$186
Oral Evaluation - Periodic	$77	No Charge	$77
Prophylaxis (Cleaning) - Adult	$138	$69	$69
Filling - 2 Surfaces	$316	$190	$126
Crown - Porcelain/Ceramic	$1,480	$949	$531
Core Buildup - (Including Any Pins)	$326	$199	$127
Extraction – Erupted Tooth	$219	$125	$94
Total Cost With Plan	$2,866	$1,532	$1,334
Comprehensive Exam	$124	No Charge	$124
Full Mouth X-rays	$186	No Charge	$186
Oral Evaluation - Periodic	$77	No Charge	$77
Prophylaxis (Cleaning) - Adult	$138	$69	$69
Filling - 2 Surfaces	$316	$190	$126
Crown - Porcelain/Ceramic	$1,480	$949	$531
Core Buildup - (Including Any Pins)	$326	$199	$127
Extraction – Erupted Tooth	$219	$125	$94
Total Cost With Plan	$2,866	$1,532	$1,334
Comprehensive Exam	$100	No Charge	$100
Full Mouth X-rays	$151	No Charge	$151
Oral Evaluation - Periodic	$58	No Charge	$58
Prophylaxis (Cleaning) - Adult	$108	$69	$39
Filling - 2 Surfaces	$265	$190	$75
Crown - Porcelain/Ceramic	$1,410	$949	$461
Core Buildup - (Including Any Pins)	$309	$199	$110
Extraction – Erupted Tooth	$188	$125	$63
Total Cost With Plan	$2,589	$1,532	$1,057
Comprehensive Exam	$92	No Charge	$92
Full Mouth X-rays	$146	No Charge	$146
Oral Evaluation - Periodic	$54	No Charge	$54
Prophylaxis (Cleaning) - Adult	$96	$69	$27
Filling - 2 Surfaces	$249	$180	$69
Crown - Porcelain/Ceramic	$1,290	$904	$386
Core Buildup - (Including Any Pins)	$292	$179	$113
Extraction – Erupted Tooth	$197	$123	$74
Total Cost With Plan	$2,416	$1,455	$961
Comprehensive Exam	$90	No Charge	$90
Full Mouth X-rays	$144	No Charge	$144
Oral Evaluation - Periodic	$51	No Charge	$51
Prophylaxis (Cleaning) - Adult	$95	$69	$26
Filling - 2 Surfaces	$238	$165	$73
Crown - Porcelain/Ceramic	$1,260	$859	$401
Core Buildup - (Including Any Pins)	$291	$159	$132
Simple Extraction	$171	$120	$51
Total Cost With Plan	$2,340	$1,372	$968
Comprehensive Exam	$110	No Charge	$110
Full Mouth X-rays	$187	No Charge	$187
Oral Evaluation - Periodic	$66	No Charge	$66
Prophylaxis (Cleaning) - Adult	$116	$75	$41
Filling - 2 Surfaces	$284	$200	$84
Crown - Porcelain/Ceramic	$1,530	$996	$534
Core Buildup - (Including Any Pins)	$350	$209	$141
Simple Extraction	$229	$131	$98
Total Cost With Plan	$2,872	$1,611	$1,261
Comprehensive Exam	$82	No Charge	$82
Full Mouth X-rays	$137	No Charge	$137
Oral Evaluation - Periodic	$51	No Charge	$51
Prophylaxis (Cleaning) - Adult	$92	$69	$23
Filling - 2 Surfaces	$225	$165	$60
Crown - Porcelain/Ceramic	$1,280	$904	$376
Core Buildup - (Including Any Pins)	$274	$159	$115
Simple Extraction	$168	$120	$48
Total Cost With Plan	$2,309	$1,417	$892
Comprehensive Exam	$85	No Charge	$85
Full Mouth X-rays	$139	No Charge	$139
Oral Evaluation - Periodic	$51	No Charge	$51
Prophylaxis (Cleaning) - Adult	$95	$69	$26
Filling - 2 Surfaces	$230	$180	$50
Crown - Porcelain/Ceramic	$1,320	$949	$371
Core Buildup - (Including Any Pins)	$284	$199	$85
Simple Extraction	$169	$125	$44
Total Cost With Plan	$2,373	$1,522	$851
Comprehensive Exam	$108	No Charge	$108
Full Mouth X-rays	$140	No Charge	$140
Oral Evaluation - Periodic	$67	No Charge	$67
Prophylaxis (Cleaning) - Adult	$114	$69	$45
Filling - 2 Surfaces	$260	$190	$70
Crown - Porcelain/Ceramic	$1,300	$949	$351
Core Buildup - (Including Any Pins)	$280	$199	$81
Extraction – Erupted Tooth	$182	$125	$57
Total Cost With Plan	$2,451	$1,532	$919
Comprehensive Exam	$98	No Charge	$98
Full Mouth X-rays	$159	No Charge	$159
Oral Evaluation - Periodic	$60	No Charge	$60
Prophylaxis (Cleaning) - Adult	$110	$75	$35
Filling - 2 Surfaces	$204	$200	$4
Crown - Porcelain/Ceramic	$1,347	$996	$351
Core Buildup - (Including Any Pins)	$332	$209	$123
Simple Extraction	$185	$131	$94
Total Cost With Plan	$2,535	$1,611	$924
Comprehensive Exam	$84	No Charge	$84
Full Mouth X-rays	$141	No Charge	$141
Oral Evaluation - Periodic	$52	No Charge	$52
Prophylaxis (Cleaning) - Adult	$96	$69	$27
Filling - 2 Surfaces	$238	$165	$73
Crown - Porcelain/Ceramic	$1,300	$859	$441
Core Buildup - (Including Any Pins)	$280	$159	$121
Extraction – Erupted Tooth	$166	$120	$46
Total Cost With Plan	$2,357	$1,372	$985
Comprehensive Exam	$94	No Charge	$94
Full Mouth X-rays	$143	No Charge	$143
Oral Evaluation - Periodic	$57	No Charge	$57
Prophylaxis (Cleaning) - Adult	$102	$69	$33
Filling - 2 Surfaces	$260	$190	$70
Crown - Porcelain/Ceramic	$1,390	$949	$441
Core Buildup - (Including Any Pins)	$298	$179	$119
Extraction – Erupted Tooth	$189	$125	$64
Total Cost With Plan	$2,533	$1,512	$1,021
Comprehensive Exam	$88	No Charge	$88
Full Mouth X-rays	$132	No Charge	$132
Oral Evaluation - Periodic	$50	No Charge	$50
Prophylaxis (Cleaning) - Adult	$90	$69	$21
Filling - 2 Surfaces	$220	$190	$30
Crown - Porcelain/Ceramic	$1,210	$949	$261
Core Buildup - (Including Any Pins)	$264	$199	$65
Extraction – Erupted Tooth	$182	$125	$57
Total Cost With Plan	$2,236	$1,532	$704
Comprehensive Exam	$96	No Charge	$96
Full Mouth X-rays	$147	No Charge	$147
Oral Evaluation - Periodic	$58	No Charge	$58
Prophylaxis (Cleaning) - Adult	$102	$69	$33
Filling - 2 Surfaces	$256	$180	$76
Crown - Porcelain/Ceramic	$1,400	$904	$496
Core Buildup - (Including Any Pins)	$298	$179	$119
Extraction – Erupted Tooth	$195	$123	$72
Total Cost With Plan	$2,552	$1,455	$1,097
Comprehensive Exam	$87	No Charge	$87
Full Mouth X-rays	$136	No Charge	$136
Oral Evaluation - Periodic	$52	No Charge	$52
Prophylaxis (Cleaning) - Adult	$93	$69	$24
Filling - 2 Surfaces	$230	$165	$65
Crown - Porcelain/Ceramic	$1,210	$859	$351
Core Buildup - (Including Any Pins)	$271	$159	$112
Extraction – Erupted Tooth	$175	$120	$55
Total Cost With Plan	$2,254	$1,372	$882
Comprehensive Exam	$88	No Charge	$88
Full Mouth X-rays	$132	No Charge	$132
Oral Evaluation - Periodic	$50	No Charge	$50
Prophylaxis (Cleaning) - Adult	$90	$69	$21
Filling - 2 Surfaces	$220	$190	$30
Crown - Porcelain/Ceramic	$1,210	$949	$261
Core Buildup - (Including Any Pins)	$264	$199	$65
Extraction – Erupted Tooth	$182	$125	$57
Total Cost With Plan	$2,236	$1,532	$704
Comprehensive Exam	$97	No Charge	$97
Full Mouth X-rays	$145	No Charge	$145
Oral Evaluation - Periodic	$58	No Charge	$58
Prophylaxis (Cleaning) - Adult	$104	$69	$35
Filling - 2 Surfaces	$256	$180	$76
Crown - Porcelain/Ceramic	$1,400	$949	$451
Core Buildup - (Including Any Pins)	$300	$199	$101
Simple Extraction	$195	$125	$70
Total Cost With Plan	$2,555	$1,522	$1033
Comprehensive Exam	$90	No Charge	$90
Full Mouth X-rays	$138	No Charge	$138
Oral Evaluation - Periodic	$53	No Charge	$53
Prophylaxis (Cleaning) - Adult	$97	$75	$22
Filling - 2 Surfaces	$241	$200	$41
Crown - Porcelain/Ceramic	$1,300	$996	$304
Core Buildup - (Including Any Pins)	$285	$209	$76
Simple Extraction	$185	$131	$54
Total Cost With Plan	$2,389	$1,611	$778
Comprehensive Exam	$90	No Charge	$90
Full Mouth X-rays	$138	No Charge	$138
Oral Evaluation - Periodic	$53	No Charge	$53
Prophylaxis (Cleaning) - Adult	$97	$75	$22
Filling - 2 Surfaces	$241	$200	$41
Crown - Porcelain/Ceramic	$1,300	$996	$304
Core Buildup - (Including Any Pins)	$285	$209	$76
Simple Extraction	$185	$131	$54
Total Cost With Plan	$2,389	$1,611	$778
Comprehensive Exam	$173	No Charge	$173
Full Mouth X-rays	$141	No Charge	$141
Oral Evaluation - Periodic	$46	No Charge	$46
Prophylaxis (Cleaning) - Adult	$87	$69	$18
Filling - 2 Surfaces	$207	$165	$42
Crown - Porcelain/Ceramic	$1,090	$799	$291
Core Buildup - (Including Any Pins)	$235	$159	$76
Extraction – Erupted Tooth	$150	$120	$30
Total Cost With Plan	$2,029	$1,312	$717
Comprehensive Exam	$110	No Charge	$110
Full Mouth X-rays	$187	No Charge	$187
Oral Evaluation - Periodic	$66	No Charge	$66
Prophylaxis (Cleaning) - Adult	$116	$75	$41
Filling - 2 Surfaces	$284	$200	$84
Crown - Porcelain/Ceramic	$1,530	$996	$534
Core Buildup - (Including Any Pins)	$350	$209	$141
Simple Extraction	$229	$131	$98
Total Cost With Plan	$2,872	$1,611	$1,261
Comprehensive Exam	Select State	Select State	Select State
Full Mouth X-rays	Select State	Select State	Select State
Oral Evaluation - Periodic	Select State	Select State	Select State
Prophylaxis (Cleaning) - Adult	Select State	Select State	Select State
Filling - 2 Surfaces	Select State	Select State	Select State
Crown - Porcelain/Ceramic	Select State	Select State	Select State
Core Buildup - (Including Any Pins)	Select State	Select State	Select State
Extraction – Erupted Tooth	Select State	Select State	Select State
Total Cost With Plan	Select State	Select State	Select State
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