Ameriplan discount dental fee schedule (Teal Region)

	AmeriPlan® Teal Fee Zip:90023 GENERAL DENTIST FEE SCHEDULE
	ADA Code Sample General Dentist Procedures Dental Office Fees Up To* AmeriPlan® Fees AmeriPlan® Savings Up To 00120 Periodic Oral Evaluation $70 $14 80% 00150 Comprehensive Oral Exam (First Visit) $118 $37 69% 00210 Intraoral - Complete Series (including bitewings) $162 $65 60% 00330 Panoramic film $134 $55 59% 01110 Prophylaxis - Adult (to include light scaling and polishing $117 $47 60% 02140 Amalgam - 1 surface, primary or permanent, per tooth $174 $70 60% 02150 Amalgam - 2 surfaces, primary or permanent, per tooth $227 $80 65% 02330 Resin based composite - 1 surface, anterior $201 $95 53% 02331 Resin based composite - 2 surface, anterior $250 $115 54% 02750 Crown - Porcelain fused to high noble metal $1365 $550 60% 03310 Root Canal - Anterior (excluding final restoration $902 $375 59% 03320 Root Canal - Bicuspid (excluding final restoration $1032 $425 59% 04355 Full Mouth Debridement $247 $95 62% 08080 Orthodontics (braces) under 19 $5000 $2100 58% 08090 Orthodontics (braces) 19 and over $5500 $2250 60%
	*Current Dental Terminology® 2007 American Dental Association, All Rights Reserved. *National Dental Advisory Service 2007 Invisalign Braces may not be included. This fee comparison is an example of the savings realized by AmeriPlan® members. Fees will vary by region.

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