Savings to Smile About
With transparent rates front and center, priced far below your dentist's normal retail fees, you can get the services you need at the prices you can afford.
| ADA Code | Procedure Description | Member Pays* |
|---|---|---|
| Diagnostic & Preventive | ||
| -- | 1st Exam & Necessary X-Rays of the Year | NO CHARGE |
| -- | 2nd Exam & Necessary X-Rays of the Year | NO CHARGE |
| -- | All Exams After 2 Yearly Complimentary | 60% Off |
| D0210 | Full Mouth X-Rays | 60% Off |
| D0220 | X-Rays - First Film | 60% Off |
| D0230 | X-Rays - Each Additional Film | 60% Off |
| D0272 | Bitewings - 2 Images | 60% Off |
| D0274 | Bitewings - 4 Images | 60% Off |
| D0330 | X-Rays - Panoramic Image | 60% Off |
| D1110 | Adult Cleaning | 25% Off |
| D1120 | Child Cleaning | 25% Off |
| D1206 | Topical Application of Fluoride - Including Varnish | 25% Off |
| D1208 | Topical Application of Fluoride - Excluding Varnish | 25% Off |
| D1351 | Sealant - Per Tooth | 25% Off |
| Restorative | ||
| D2330 | Filling - 1 Surface, Anterior | 25% Off |
| D2331 | Filling - 2 Surfaces, Anterior | 25% Off |
| D2332 | Composite Filling - Three Surface, Anterior | 25% Off |
| D2391 | Filling, 1 Surface, Posterior | 25% Off |
| D2392 | Composite Filling - Two Surface, Posterior | 25% Off |
| D2393 | Composite Filling - Three Surface, Posterior | 25% Off |
| D2740 | Crown - Porcelain/Ceramic | 25% Off |
| D2750 | Crown - Porcelain/High Noble Metal | 25% Off |
| D2920 | Crown - Recementation | 25% Off |
| Endodontics & Periodontics | ||
| D3310 | Root Canal - Anterior | 40% Off |
| D3320 | Root Canal - Bicuspid | 40% Off |
| D3330 | Root Canal - Molar | 40% Off |
| D4341 | Perio Scaling/Root Planing - 4+ Teeth | 40% Off |
| D4342 | Perio Scaling/Root Planing - 1-3 Teeth | 40% Off |
| D4910 | Periodontal Maintenance | 40% Off |
| Prosthodontics & Oral Surgery | ||
| D5110 | Complete Denture | 40% Off |
| D5213 | Partial Denture w/ Metal Frame - upper or lower | 40% Off |
| D7111 | Extraction - Coronal Remnants | 30% Off |
| D7140 | Simple Extraction | 25% Off |
| D7210 | Surgical Extraction | 30% Off |
| D7230 | Extraction - Impacted | 30% Off |
| Orthodontics | ||
| Limited Orthodontics | 10% Off | |
| Comprehensive Orthodontics | 10% Off | |
| Miscellaneous | ||
| SuperMouth® Products | 10% Off |
*Services listed on Summary of Discounts, with the exception of Orthodontic services, are performed by your selected general dentist. Certain procedures may not be within the scope of practice or the ability of the general dentist. In such cases, if a participating specialist is available to perform such procedures they will be provided at a 10-60% discount off the participating specialist's usual and customary fee for such procedures.