Office Fees

15 Most Common Procedures

 Code  Description  Fee
 D0120  Periodic Oral Evaluation  $68
 D1110  Prophylyaxis-Adult  $116
 D0220  Intraoral-Perioapical 1st Film  $35
 D0274  Bitewings-Four Films  $80
 D0230  Intraoral-Perioapical Each Add’l  $29
 D1206  Topical Fluoride Varnish  $52
 D1120  Prophylaxis-Child  $88
 D2392  Resin-Composite-2S, Posterior  $275
 D2391  Resin-Composite-1S, Posterior  $216
 D0210  Intraoral-Complete Series (BW)  $164
 D0272  Bitewings-Two Films  $54
 D4910  Periodontal Maintenance  $174
 D1351  Sealant-Per Tooth  $62
 D2750  Crown-Porc. Fuse High Noble Mtl.  $1420
 D9230  Analgesia-Inhal of Nitrous Oxide  $91

All fees are estimates as actual charges are dependent on the circumstances at the time a service is rendered. If you are covered by health insurance, you are strongly encouraged to consult with your health insurer to determine accurate information about your financial responsibility for a particular service provided at this office.  If you are not covered by health insurance, you are strongly encouraged to contact our office to discuss payment options and the actual amount of your financial responsibility.

We strive for to make our patients part of our family!

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