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 |
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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 |