| Comprehensive Oral Exam |
$108 |
No Charge |
$108 |
| Complete Full-Mouth X-rays |
$168 |
No Charge |
$168 |
| Adult Preventive Cleanings |
$124 |
$75 |
$49 |
| Composite filling - One Surface, Posterior |
$235 |
$130 |
$105 |
| Crown - Porcelain/Ceramic Substrate |
$1,608 |
$1,048 |
$560 |
| Crown Build-up |
$355 |
$230 |
$125 |
| Extraction, Erupted Tooth |
$209 |
$125 |
$84 |
| TOTAL |
$2,807 |
$1,608 |
$1,199 |
| Comprehensive Oral Exam |
$110 |
No Charge |
$110 |
| Complete Full-Mouth X-rays |
$165 |
No Charge |
$165 |
| Adult Preventive Cleanings |
$121 |
$65 |
$56 |
| Composite filling - One Surface, Posterior |
$242 |
$127 |
$115 |
| Crown - Porcelain/Ceramic Substrate |
$1,486 |
$922 |
$564 |
| Crown Build-up |
$369 |
$150 |
$219 |
| Extraction, Erupted Tooth |
$206 |
$125 |
$81 |
| TOTAL |
$2,699 |
$1,389 |
$1,310 |
| Comprehensive Oral Exam |
$113 |
No Charge |
$113 |
| Complete Full-Mouth X-rays |
$168 |
No Charge |
$168 |
| Adult Preventive Cleanings |
$120 |
$65 |
$55 |
| Composite filling - One Surface, Posterior |
$241 |
$127 |
$114 |
| Crown - Porcelain/Ceramic Substrate |
$1,461 |
$1,022 |
$439 |
| Crown Build-up |
$347 |
$160 |
$187 |
| Extraction, Erupted Tooth |
$202 |
$125 |
$77 |
| TOTAL |
$2,652 |
$1,499 |
$1,153 |
| Comprehensive Oral Exam |
$106 |
No Charge |
$106 |
| Complete Full-Mouth X-rays |
$165 |
No Charge |
$165 |
| Adult Preventive Cleanings |
$121 |
$72 |
$49 |
| Composite filling - One Surface, Posterior |
$233 |
$129 |
$104 |
| Crown - Porcelain/Ceramic Substrate |
$1,579 |
$1,063 |
$516 |
| Crown Build-up |
$349 |
$228 |
$121 |
| Extraction, Erupted Tooth |
$205 |
$125 |
$80 |
| TOTAL |
$2,758 |
$1,617 |
$1,141 |
| Comprehensive Oral Exam |
$121 |
No Charge |
$121 |
| Complete Full-Mouth X-rays |
$176 |
No Charge |
$176 |
| Adult Preventive Cleanings |
$121 |
$65 |
$56 |
| Composite filling - One Surface, Posterior |
$234 |
$130 |
$104 |
| Crown - Porcelain/Ceramic Substrate |
$1,650 |
$903 |
$747 |
| Crown Build-up |
$413 |
$250 |
$163 |
| Extraction, Erupted Tooth |
$223 |
$125 |
$98 |
| TOTAL |
$2,938 |
$1,473 |
$1,465 |
| Comprehensive Oral Exam |
$110 |
No Charge |
$110 |
| Complete Full-Mouth X-rays |
$168 |
No Charge |
$168 |
| Adult Preventive Cleanings |
$138 |
$80 |
$58 |
| Composite filling - One Surface, Posterior |
$227 |
$130 |
$97 |
| Crown - Porcelain/Ceramic Substrate |
$1,662 |
$1,076 |
$586 |
| Crown Build-up |
$372 |
$240 |
$132 |
| Extraction, Erupted Tooth |
$238 |
$125 |
$113 |
| TOTAL |
$2,915 |
$1,651 |
$1,264 |
| Comprehensive Oral Exam |
$113 |
No Charge |
$113 |
| Complete Full-Mouth X-rays |
$173 |
No Charge |
$173 |
| Adult Preventive Cleanings |
$139 |
$75 |
$64 |
| Composite filling - One Surface, Posterior |
$221 |
$135 |
$86 |
| Crown - Porcelain/Ceramic Substrate |
$1,609 |
$1,126 |
$483 |
| Crown Build-up |
$360 |
$208 |
$152 |
| Extraction, Erupted Tooth |
$230 |
$125 |
$105 |
| TOTAL |
$2,845 |
$1,669 |
$1,176 |
| Comprehensive Oral Exam |
$117 |
No Charge |
$117 |
| Complete Full-Mouth X-rays |
$164 |
No Charge |
$164 |
| Adult Preventive Cleanings |
$113 |
$65 |
$48 |
| Composite filling - One Surface, Posterior |
$221 |
$121 |
$100 |
| Crown - Porcelain/Ceramic Substrate |
$1,511 |
$898 |
$613 |
| Crown Build-up |
$391 |
$250 |
$141 |
| Extraction, Erupted Tooth |
$209 |
$125 |
$84 |
| TOTAL |
$2,726 |
$1,459 |
$1,267 |
| Comprehensive Oral Exam |
$99 |
No Charge |
$99 |
| Complete Full-Mouth X-rays |
$147 |
No Charge |
$147 |
| Adult Preventive Cleanings |
$101 |
$61 |
$40 |
| Composite filling - One Surface, Posterior |
$202 |
$122 |
$80 |
| Crown - Porcelain/Ceramic Substrate |
$1,471 |
$1,030 |
$441 |
| Crown Build-up |
$303 |
$164 |
$139 |
| Extraction, Erupted Tooth |
$197 |
$125 |
$72 |
| TOTAL |
$2,520 |
$1,502 |
$1,018 |
| Comprehensive Oral Exam |
$99 |
No Charge |
$99 |
| Complete Full-Mouth X-rays |
$174 |
No Charge |
$174 |
| Adult Preventive Cleanings |
$103 |
$65 |
$38 |
| Composite filling - One Surface, Posterior |
$209 |
$115 |
$94 |
| Crown - Porcelain/Ceramic Substrate |
$1,454 |
$937 |
$517 |
| Crown Build-up |
$340 |
$180 |
$160 |
| Extraction, Erupted Tooth |
$199 |
$125 |
$74 |
| TOTAL |
$2,578 |
$1,422 |
$1,156 |
| Comprehensive Oral Exam |
$114.00 |
Select State |
Select State |
| Complete Full-Mouth X-rays |
$171.00 |
Select State |
Select State |
| Adult Preventive Cleanings |
$125.00 |
Select State |
Select State |
| Composite filling - One Surface, Posterior |
$235.00 |
Select State |
Select State |
| Crown - Porcelain/Ceramic Substrate |
$1,522.00 |
Select State |
Select State |
| Crown Build-up |
$313.00 |
Select State |
Select State |
| Extraction, Erupted Tooth |
$241.00 |
Select State |
Select State |
| Total |
$2,721.00 |
Select State |
Select State |
