| Service | Average Price1 | Member Price | Member Savings | % Savings |
|---|---|---|---|---|
| Routine 6 Month Check-Up | $42.00 | $23.00 | $19.00 | 46% |
| In Depth Check-Up | $72.00 | $33.00 | $39.00 | 54% |
| Full Mouth X-Rays | $125.00 | $59.00 | $66.00 | 53% |
| Four Bitewing X-Rays | $54.00 | $27.00 | $28.00 | 51% |
| Panoramic Film | $101.00 | $48.00 | $53.00 | 53% |
| Adult Teeth Cleaning | $77.00 | $44.00 | $33.00 | 43% |
| Child Teeth Cleaning | $53.00 | $31.00 | $23.00 | 42% |
| Protective Sealant / Tooth | $46.00 | $20.00 | $23.00 | 49% |
| 1 Surface White Filling for U or L Front Tooth | $112.00 | $55.00 | $57.00 | 51% |
| Single Crown - Porcelain on High Noble Metal | $918.00 | $565.00 | $354.00 | 39% |
| Single Crown - Porcelain on Noble Metal | $876.00 | $548.00 | $328.00 | 37% |
| Root Canal Treatment - Molar | $1,030.00 | $549.00 | $481.00 | 47% |
| Perio Scaling and Root Planing (Per Quadrant) | $219.00 | $120.00 | $99.00 | 45% |
| Full Upper Denture | $1,398.00 | $715.00 | $683.00 | 49% |
1Sample Average of National Dental Fees. Fees may vary slightly by region. (updated 6/2009)
Fee schedules may change without notice. Consult your plan dentist for current fees before beginning treatment.