Periodontic Rates & Procedures
|
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% |