Procedure Description

Usual Fee

Member

 Pay

Member Savings

Routine 6 Month Check-Up

$40

$24

$16

In Depth Check-Up

$67

$37

$30

Full Mouth X-Rays

$104

$65

$39

Four Bitewing X-Rays

$49

$25

$24

Panoramic Film

$87

$50

$37

Adult Teeth Cleaning

$75

$44

$31

Child Teeth Cleaning

$53

$32

$21

Protective Sealant / Tooth

$43

$26

$17

1 Surface White Filling for U or L Front Tooth

$121

$71

$50

Single Crown - Porcelain on High Noble Metal

$867

$566

$301

Single Crown - Porcelain on Noble Metal

$838

$549

$289

Root Canal Treatment - Molar

$829

$522

$307

Perio Scaling and Root Planing (Per Quadrant)

$208

$123

$85

Full Upper Denture

$1,252

$725

$527