Fee Schedule

D0150 Comprehensive Oral Evaluation

D0220 Intraoral Periapical X-ray

D1110 Prophylaxis - Adult

D2330 Resin based composite - One Surface - anterior

D2331 Resin based composite - Two Surfaces - anterior

D2332 Resin based composite - Three Surfaces - anterior

D2391 Resin based composite - One Surface - posterior

D2392 Resin based composite - Two Surfaces - posterior

D2393 Resin based composite - Three Surfaces - posterior

D2751 Crown - Porcelain Fused to Metal

D2920 Recement Crown

D2952 Cast Post and Core in addition to Crown

D3310 Root Canal Anterior (Excluding Final Restoration)

D3320 Root Canal Bicuspid (Excluding Final Restoration)

D3330 Root Canal Molar (Excluding Final Restoration)

D4263 Bone Replacing Bone Graft - First Side

D4341 Periodontal scaling and root planning - Per Quadrant

D5110 Complete Denture - Maxillary

D5120 Complete Denture - Mandibular

D5211 Maxillary Partial Denture 

D5212 Mandibular Partial Denture

D6010 Surgical Placement of Endosteal Implant

D6056 Prefabricated abutment - Includes placement

D6060 Abutment Supported PFM Crown

D7140 Exraction, erupted tooth

D7240 Surgical Removal of Impacted Tooth - Wisdom Tooth

D8090 Comprehensive Orthodontic Treatment 

$       0

$       0

$     35

$     60

$     70

$     90

$     60

$     70

$     90

$   220

$     20

$   100

$   230

$   240

$   250

$   400

$     50

$   450

$   450

$   450

$   450

$   849

$      0

$   220

$     60

$   150

$1,800

  • Grey Facebook Icon

© 2020 by DAS Dental Group