| SERVICE |
Cost In U.S. |
Cost at DentiCenter |
| Periodic Oral Evaluation |
$80 |
$18 |
| Comprehensive Oral Evaluation |
$120 |
$29 |
| Intraoral Complete Series (includes bitewings) |
$190 |
$46 |
| Intraoral (periapical first film) |
$50 |
$12 |
| Panoramic Film |
$140 |
$35 |
| Prophylaxis (adult) |
$170 |
$41 |
| Prophylaxis (child) |
$140 |
$29 |
| Topical Application of Flouride (child) |
$100 |
$23 |
| Sealant (per tooth) |
$100 |
$40 |
| Amalgam (one surface) |
$190 |
$46 |
| Amalgam (two surfaces) |
$248 |
$58 |
| Resin Based Composite (one surface - anterior) |
$280 |
$69 |
| Resin Based Composite (two surface - posterior) |
$280 |
$69 |
| Crown (porcelain/ceramic substrate) |
$1500 |
$450 |
| Crown (porcelain fused to base metal) |
$900 |
$311 |
| Crown (full cast predominantly base metal) |
$850 |
$270 |
| Recement Crown |
$100 |
$30 |
| Core Buildup (including any pins) |
$200 |
$81 |
| Prefabricated post and core & crown |
$230 |
$92 |
| Labial Veneer (porcelain laminate) |
$1000 |
$350 |
| Endodontic Therapy (anterior tooth) |
$750 |
$265 |
| Endodontic Therapy (bicuspid tooth) |
$850 |
$276 |
| Endodontic Therapy (molar) |
$1000 |
$299 |
| Retreatment of previous root canal - bicuspid |
$850 |
$276 |
| Retreatment of previous root canal - molar |
$1000 |
$299 |
| Osseous Surgery (per quadrant) (including flap entry & closure) |
$1000 |
$299 |
| Bone Replacement Graft |
$900 |
$250 |
Periodontal Scaling & Root Planning (per quadrant)
|
$240 |
$58 |
| Complete Denture (maxillary) |
$900 |
$518 |
| Complete Denture (mandibular) |
$900 |
$518 |
| Immediate Denture (maxillary) |
$900 |
$518 |
| Immediate Denture (mandibular) |
$900 |
$518 |
| Mandibular Partial Denture (resin based) |
$600 |
$288 |
| Maxillary Partial Denture (cast metal) |
$850 |
$460 |
| Mandibular Partial Denture (cast metal) |
$850 |
$460 |
| Maxillary Partial Denture (flexible base) |
$1500 |
$600 |
| Removable Unilateral Partial Denture |
$1500 |
$600 |
| Interim Complete Denture (maxillary) |
$400 |
$161 |
| Interim Complete Denture (mandibular) |
$400 |
$161 |
| Interim Partial Denture (maxillary) |
$400 |
$161 |
| Interim Partial Denture (mandibular) |
$400 |
$161 |
| Surgical Placement of Implant Body |
$2000 |
$800 |
| Abutment Supported porcelain/ceramic crown |
$1200 |
$450 |
| Pontic - (cast predominantly base metal) |
$800 |
$450 |
| Pontic - (porcelain / ceramic) |
$1200 |
$450 |
| Core buildup for retainer (including pins) |
$180 |
$81 |
| Extraction, erupted tooth or exposed root |
$100 |
$60 |
| Removal of impacted tooth (soft tissue) |
$300 |
$104 |
| Removal of impacted tooth (pargiany bony) |
$400 |
$202 |
| Surgical Removal of Tooth Roots |
$300 |
$104 |
| Surgical Access of an Erupted Tooth |
$250 |
$144 |
| Comprehensive Orthodontic Treatment |
$3000 |
$1725 |
| Pre-Orthodontic Treatment Visit |
$100 |
$50 |
| Occlusal Guard, by Report |
$250 |
$100 |
| External Bleaching - per arch |
$250 |
$100 |
