Office Fees

15 Most Common Procedures

 Code  Description  Fee
 0120  Recall Exam  $59
 0140  Problem Focused Exam  $84
 0150  Comprehensive Exam  $94
 0210  Complete Series of Radiographs  $148
 0220  Periapical Radiograph  $32
 0230  Additional Periapical Radiograph  $25
 0274  Bite-wing Radiographs  $71
 1110  Prophylaxis Adult  $105
 1120  Prophylaxis Child  $78
 1206  Fluoride Varnish  $47
 1351  Sealants  $59
 2391  Surface Composite Resin / One Surface  $198
 2392  Surface Composite Resin / Two Surfaces  $252
 2740  All Porcelain Crown  $1210
 2950  Build-up Restoration  $289