Office Fees
Preventative Care
Cost
Dental Code
Cleaning
$92-$123
D1110/D1120
Comprehensive Exam
$112
D0150
Fluoride
$51
D1206
Cleaning, Exam, Full Series of X-Rays, Fluoride
$406-$437
D0150
Emergency Exam
$99 (excludes X-rays)
D0140
Deep Cleaning
$340 per quadrant
D4341
Restorative Dental Services
Cost
Dental Code
Dental Implants
$1,075-$2,000
D6010/D6057/D6058
Porcelain Crown
$1,349-$1,591
D2740
Extractions (per tooth)
$126-$320
Posterior Composite (White) Fillings
$231-$446
Anterior Composite (White) Fillings
$213-$396
Complete Upper Dentures
$2,000
D5110
Complete Lower Dentures
$2,000
D5120
Partial Upper Dentures (All Resin)
$1,349
D5211
Partial Lower Dentures (All Resin)
$1,349
D5212
Partial Upper Dentures (Metal Frame)
$2,100
D5213
Partial Lower Dentures (Metal Frame)
$2,100
D5214
Cosmetic Dental Services
Cost
Dental Code
Take-Home Whitening Trays
$328
Porcelain Veneers
$1,350
Orthodontics
$5,600
D8060-D8090
Additional Dental Services
Cost
Dental Code
Nitrous Sedation
$100
D9230b
