Top 15 procedures

In 2017 SB 65 passed requiring all healthcare providers to provide a list of their top 15 performed procedures and their fees without any insurance or discount associated.

 

Code Number	Explanation	Fee
D1110	Adult Dental Cleaning and Prophylaxis	$97
D0120	Periodic Exam of teeth	$62
D2392	Filling on a tooth that is on 2 different surfaces	$293
D0220	1st X-ray that shows the root of a tooth	$29
D0230	Additional X-ray that shows the roots of teeth	$29
D0274	X-rays that show cavities between teeth	$79
D1120	Child's Cleaning	$71
D0210	Complete set of x-rays showing all teeth and roots	$163
D7140	Extraction of a tooth without having to move gums or remove bone	$162
D2391	Composite filling on one surface of a tooth	$218
D2331	Filling on front tooth on two surfaces	$234
D2950	Core Buildup to restore a tooth to allow a crown	$340
D0150	Comprehensive Exam generally a new patient	$77
D2330	Filling on front tooth limited to one surface
D2740	All Porcelain Crown	$1,285

 

“The health care price listed for any given health care service is an estimate. Actual charges for the health care service are dependent on the circumstances, including any complications or exceptional treatment, at the time the service is rendered. 

If you are covered by health insurance or a dental plan, you are strongly encouraged to consult with your insurer or plan to determine accurate information about your financial responsibility for a particular health care service provided by a health care provider at this office. If you are not covered by health insurance or a dental plan, you are strongly encouraged to contact our billing office at [insert telephone number] to discuss payment options prior to receiving a health care service from a health care provider at this office since posted health care prices may not reflect the actual amount of your financial responsibility.”