Periodontics: All Locations
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About This Schedule: We have included most common procedures that apply to the dental specialty shown. If a procedure is not listed, or if your dentist needs to perform a variation of a listed procedure, the NYDN participating dentist will charge a fee that is consistent with rate reductions shown on this schedule. There may be some exception for certain brand name products. Network fees for professional services may change from time time, without prior notice, and we encourage our participating dentists and members to review fee schedules posted on this website for updates that may apply.
 
If a Fee Range is shown - this reflects variation that cannot be reduced readily to a single average fee. Professional fees may vary due to expenses associated with office location, support staff and special equipment. We suggest that you ask your dentist about his/her UCR (usual, customary and reasonable fee) for the procedure in question - in this way you will be able to determine the savings afforded by the network fee charged.

The last two columns on the right show typical savings per procedure and percentage of rate reduction for each procedure.


This is a Cooperative Dental Plan. If your membership fee is not returned thru Plan Savings, we are not meeting our minimum goal. We seek member feedback on dental fees and all aspects of the plan. Savings shown for Diagnostic and Preventive visits alone should cover all or most of membership cost. Utilization of additional Dental Services or Coordination of Benefits with conventional dental insurance plans should result in greater savings.

To track plan utilization and member savings, NYDN may ask participating dentists to document NYDN fees actually charged, compared to usual and customary fees. NYDN may remit an administrative fee to dentists for this service, where applicable. Results of this fee survey will be made available to dentists and members to illustrate the cost effectiveness of this plan. For reasons of confidentiality, NYDN never collects or distributes medical or dental information; we are concerned only with fee information.

Note: For some procedures listed on this schedule we have posted an alternate, higher fee that may apply at certain Manhattan practice locations only. Please consult with your dentist about this.

Dentists: Please Verify Member Status at each member visit.
Periodontic Rates & Procedures
Services are provided by a Periodontist, a Specialist with additional training in this field. 		Regional Fee Network Fee Typical Network Savings Typical % Savings
Periodontal Exam - Comprehensive $100 - $125 $65 $47 42%
Periodontal Exam - Periodic Exam $65 $40 $25 38%
Periodontal Recall (Exam & Maintenance following Scaling and Root Planing) $130 - $180 $100 $55 35%
Periodontal Recall (Exam & Maintenance following Scaling and Root Planing)
Alternate Fee - Certain Manhattan Locations Only - Please consult with your dentist.		 $140 - $190 $110 $55 34%
Periodontal Charting $65 $40 $25 38%
Diagnostic Impressions (models both arches) $135 - $265 $100 $100 50%
Diagnostic Waxup (includes lab fees) $225 - $325 $175 $100 31%
First Periapical X-ray $25 $15 $10 40%
Each Additional Periapical X-ray $20 $10 $10 50%
X-Ray Bite Wings (complete) $80 $45 $35 31%
X-Ray Panorex $125 $85 $40 32%
X-Ray Full Mouth, Including Bitewings (complete) $115 - $165 $85 $60 39%
Note on Prophylaxis: If Periodontal Gum Disease is present, quarterly visits for Prophylaxis may be recommended by your dentist. You will note significant NYDN savings on Prophylaxis procedures.        
Prophylaxis (when performed by the Periodontist) $140 $90 $50 36%
Prophylaxis (when performed by the Hygienist) $110 $65 $45 41%
Root planing, per quadrant*
*More complicated cases. (includes local anesthesia)		 $325 $225 $100 31%
Chemotherapeutic agents, per tooth $65 - $90 $45 $35 44%
Chemotherapeutic agents, per quadrant $160 - $180 $110 $60 35%
Full Mouth Scaling - Per Quad $275 - $325 $175 $125 42%
Full Mouth Scaling - Per Quad
Alternate Fee - Certain Manhattan Locations Only - Please consult with your dentist.		 $275 - $375 $215 $135 34%
Desensitizing (per quad) $60 - $75 $50 $18 26%
Intra-Oral Incision and Drainage of Abcess $250 - $400 $175 $150 46%
Osseous surgery, per quadrant $1050 - $1200 $800 $325 29%
Osseous surgery, per quadrant
Alternate Fee - Certain Manhattan Locations Only - Please consult with your dentist.		 $1100 - $1350 $850 $375 31%
Mucogingival surgery, per quadrant $1050 - $1200 $825 $250 27%
Note: Crown Lengthening may involve more than one tooth. If a contiguous tooth is included, the cost per addl. tooth may be relatively modest. Please consult with your dentist about details.        
Crown Lengthening (per tooth - see above note) $900 - $1100 $775 $225 22%
Connective Tissue Grafts, per tooth $800 - $1050 $600 $225 36%
Connective Tissue Grafts, per tooth
Alternate Fee - Certain Manhattan Locations Only - Please consult with your dentist.		 $850 - $1150 $675 $325 32%
Free Gingival Grafts, per tooth $800 - $1050 $600 $225 35%
Free Gingival Grafts, per tooth
Alternate Fee - Certain Manhattan Locations Only - Please consult with your dentist.		 $850 - $1150 $675 $325 32%
Bone graft, first tooth, per quad. $600 $475 $125 29%
Bone graft, each additional tooth, per quad. $325 $225 $100 31%
Socket Graft (single tooth) $275 - $350 $225 $87 20%
Guided tissue regeneration, per tooth $225 $160 $65 29%
Biologic Materials to promote tissue regeneration (per site) $450 $350 $100 22%
Ridge Preservation (with straight bone graft) $500 $325 $175 35%
Ridge Preservation (with bone graft and guided tissue regeneration) $750 $550 $200 26%
Soft Tissue Allograft (per site) $850 - $950 $750 $125 17%
Simple Tooth Extraction $250 $170 $80 32%
Surgical Tooth Extraction $400 $280 $120 30%
Abutment (implant - rates may vary due to material + lab costs) $550 $400 $150 27%
Dental implant - Surgical fee, does not include Crown, Abutment or Bone Graft $1800 - $2300 $1500 $550 27%
Dental implant - Surgical fee, does not include Crown, Abutment or Bone Graft
Alternate Fee - Certain Manhattan Locations Only - Please consult with your dentist.		 $1850 - $2450 $1650 $500 33%
Anesthesia and Analgesia - In some cases, the cost of Inhalation Analgesia (nitrous oxide) may be included in cost of the procedure. In other cases, a separate fee, as shown on this schedule, may apply. In general, fees for Analgesia and for IV Sedation are based upon time required for each procedure. In some dental procedures, conventional medical insurance may cover a portion of the surgical or anesthesia fees. Consult with your dentist about his/her fees for Analgesia and Anesthesia to determine network savings.        
Inhalation Analgesia (Nitrous Oxide) $65 - $95 $45 $35 44%
IV Conscious Sedation (first 30 minutes) $350 - $500 $250 $175 41%
IV Conscious Sedation (additional 15 minutes) $180 - $220 $100 $100 50%

*Regional fees posted are representative of usual and customary fees charged by New York Dental Network, LLC participating dentists for patients who do not participate in a dental benefits plan. Some fee variation was found due to differences in office overhead, materials, lab fees, and other professional considerations.

*Network fees shown are the actual fees members will pay to the participating dentist. For procedures not shown, or variations of listed procedures, similar network fee reductions will apply in most cases. An exception may apply in the case of certain brand name dental products or services. Additionally, fee variations may be based upon degree of difficulty and time and materials involved in treatment. Please consult with your dentist prior to course of treatment.

*When a network fee range is shown, the usual and customary fee (UCR) of the dentist will determine the network fee to be paid by NYDN member. For example, if the dentist's UCR fee falls in the middle of regional fee range, the dentist will charge NYDN member a fee in the middle of network fee range. If the dentist's usual fee for a given procedure is lower than the stated network fee, the dentist agrees to charge usual fee, resulting in additional savings for network members.