SAMPLE PRICES

SAMPLE PRICES

PROCEDURE PROCEDURE CODE AVERAGE COST
RECALL EXAM 01202 $67.00
COMPLETE ADULT EXAM 01103 $105.92
SCALING – 1 UNIT 11111 $70.10
FLUORIDE 12112 $30.26
COMPOSITE ANTERIOR FILLING – 1 SURFACE 23111 $142.49
COMPOSITE MOLAR FILLING – 1 SURFACE 23321 $156.15
CROWN – PORCELAIN FUSED TO METAL 27211 $861.59 + LAB FEES
ROOT CANAL – 1 CANAL 33111 $691.15
EXTRACTION – SIMPLE 71101 $140.21
EMERGENCY EXAM 01205 $67.05