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| Codes | Procedure | Standard Fee | Member Fee |
|---|---|---|---|
D2330 | 1 surface anterior composite | $220 | $135 |
D2331 | 2 surface anterior composite | $235 | $165 |
D2332 | 3 surface anterior composite | $255 | $190 |
D2391 | 1 surface posterior composite | $220 | $135 |
D2392 | 2 surface posterior composite | $235 | $165 |
D2393 | 3 surface posterior composite | $255 | $190 |
| Codes | Procedure | Standard Fee | Member Fee |
|---|---|---|---|
| D2740 | All Porcelain | $1,300 | $975 |
| D2750 | Porcelain fused to metal | $1,100 | $875 |
D2950/ D2954 | Core build up/ Post and Core | $190/ $225 | FREE |
| Codes | Procedure | Standard Fee | Member Fee |
|---|---|---|---|
| D3310 | Anterior root canal | $906 | $680 |
| D3320 | Porcelain fused to metal | $1,040 | $780 |
D3330 | Core build up/Post and Core | $1,300 | $980 |
| Codes | Procedure | Standard Fee | Member Fee |
|---|---|---|---|
D7140 | Simple extraction | $225 | $170 |
D7210 | Surgical extraction | $275 | $200 |
D7230 | Impacted wisdom tooth | $350 | $275 |
| Codes | Procedure | Standard Fee | Member Fee |
|---|---|---|---|
D4355 | Full-mouth debridement | $225 | $170 |
| D4341 | Deep cleaning (per quadrant) | $250 | $187 |
D4342 | Deep cleaning 1 – 3 teeth | $180 | $135 |
| Peridex antibiotic irrigation and rinse | $25 | FREE |
| Codes | Procedure | Standard Fee | Member Fee |
|---|---|---|---|
D6110/ D6120 | Complete dentures (each) | $1,300 | $975 |
D6211/ D6212 | Acrylic partial (each) | $1,200 | $935 |
D6213/ D6214 | Cast frame partial (each) | $1,550 | $1,140 |
D6225/ D6226 | Flexible partial (each) | $1,550 | $1,140 |
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Individual
$150 / año luego de la primera visita
1 persona
Flúor gratis
Rayos X gratis
Exámenes gratis
Limpiezas ilimitadas
Hasta 25% de descuento en la mayoría de los procedimientos
Familiar
$250 / anual
Hasta 4 personas
Flúor gratis
Radiografías gratis
Exámenes gratis
Limpiezas ilimitadas
Hasta 25% de descuento en la mayoría de los procedimientos
