In Office Dental Plan
Discount Dental Plan
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In Office Dental Plan Description
Welcome to Family Cosmetic Dentistry In-Office Discount Dental Plan. This plan was developed especially for patients who do not have dental insurance or whose employer no longer provides it. As regular dental care is an integral part of your overal health, we have created this plan to support you in your efforts. We hope that you utilize this plan to improve and maintain the oral health for yourself and your family for years to come. Keep in mind that this plan is NOT DENTAL INSURANCE, but it has a number of great features that are very exciting:
NO ANNUAL MAXIMUM BENEFIT
NO WAITING PERIODS–start your treatment today!
NO DEDUCTIBLES
No Claim Forms or Pre-Authorizations
No ID Card Necessary
Cosmetic Dentistry included
Two Routine Exams
Two Bitewing X-rays (Children) or Four Bitewing X-rays (Adult)
Two Routine Cleaning (Unless gum disease present)
Two Topical Fluoride Application for Children up to age 16
Unlimited Emergency Exam and X-ray
All eligible dental treatment discounted by 20%
We love to see you smile!
Give us a call to schedule your dental appointment
More Offers
Implants
Starting at $1500
Dentures
Starting at $1450
Veneers
Starting at $950
Enrollment Fees
| Individual Member | $200 / year |
| Individual and Spouse | $250 / year |
| Family with up to 4 Members | $350 / year |
| Additional Child | $95 / year |
DIAGNOSTIC
| PROCEDURE | STANDARD FEE | WITH PLAN |
|---|---|---|
| D0110 Initial Exam | $50 | no charge |
| D0120 Periodic Oral Exam | $35 | no charge |
| D0210 Intraoral Complete Series | $80 | no charge |
| D0220 Intraoral Periapical | $25 | no charge |
| D0274 Bitewings Two Films | $50 | no charge |
| D0330 Panoramic Film | $75 | no charge |
PREVENTATIVE
| PROCEDURE | STANDARD FEE | WITH PLAN |
|---|---|---|
| D1110 Prophylaxis Adult (1 every 6 months) | $80 | no charge Each Additional $60 |
| D1120 Prophylaxis Child (1 every 6 months) | $60 | no charge Each Additional $40 |
| D1203 Fluoride - Child | $40 | no charge |
| D1351 Sealant - Per Tooth | $85 | $40 |
RESTORATIVE BASIC
| PROCEDURE | STANDARD FEE | WITH PLAN |
|---|---|---|
| D2330 Resin Anterior 1 Surface | $175 | $140 |
| D2331 Resin Anterior 2 Surface | $195 | $156 |
| D2332 Resin Anterior 3 Surface | $205 | $164 |
| D2335 Resin Anterior 4+ Surface | $225 | $180 |
| D2391/D2140 Resin Posterior 1 Surface | $175 | $140 |
| D2392/D2150 Resin Posterior 2 Surface | $195 | $156 |
| D2393/D2160 Resin Posterior 3 Surface | $205 | $164 |
| D2394/D2161 Resin Posterior 4+ Surface | $225 | $180 |
PERIODONTAL
| PROCEDURE | STANDARD FEE | WITH PLAN |
|---|---|---|
| D4341 Root Planning Scaling Per Quadrant | $198 | $158 |
| D4342 Root Planning Scaling 1-3 Teeth | $110 | $88 |
| D4355 Full Mouth Debridement | $90 | $72 |
| D4910 Periodontal Maintenance | $100 | $80 |
| D9610 Irrigation | $35 | $28 |
RESTORATIVE MAJOR
| PROCEDURE | STANDARD FEE | WITH PLAN |
|---|---|---|
| D2740 Single Crown Porcelain/Ceramic | $1050 | $892 |
| D2950 Core Build Up | $210 | $168 |
| D2954 Post Core Build Up | $210 | $168 |
| D2962 Veneer Lab Processed Porcelain | $950 | $807 |
ENDODONTICS
| PROCEDURE | STANDARD FEE | WITH PLAN |
|---|---|---|
| D3110 Pulp Cap Direct | $75 | $50 |
| D3310 Root Canal Anterior | $695 | $590 |
| D3320 Root Canal Bicuspid | $895 | $760 |
| D3330 Root Canal Molar | $1207 | $1050 |
ORAL SURGERY
| PROCEDURE | STANDARD FEE | WITH PLAN |
|---|---|---|
| D7140 Simple Extraction | $150 | $127 |
| D7210 Surgical Extraction | $250 | $187 |
| D7220 Impacted Wisdom Soft Tissue | $300 | $255 |
| D7230 Partially Impacted Wisdom | $350 | $297 |
MISCELLANEOUS
| PROCEDURE | STANDARD FEE | WITH PLAN |
|---|---|---|
| D9110 Palliative Treatment | $95 | $76 |
| D9940 Occlusal Guard | $425 | $361 |
| D9951 Occlusal Adjustment (One Visit) | $75 | $68 |
DENTAL IMPLANTS
| PROCEDURE | STANDARD FEE | WITH PLAN |
|---|---|---|
| D6010 Endosseous Implant | $1500 | $1200 |
| D6057 Implant Crown | $1550 | $1240 |
| D6058 Abutment | $800 | $640 |
PARTIALS & DENTURES
| PROCEDURE | STANDARD FEE | WITH PLAN |
|---|---|---|
| D5110 Upper Denture | $1450 | $1000 |
| D5120 Lower Denture | $1450 | $1000 |
