This schedule is valid at time of printing. Participating dentists and network members should check fee schedules posted on this website of for future changes and updates.

Prosthodontics

Prosthodontic Rates & Procedures
Regional Fee Network Fee Typical Network Savings Typical % Savings
Initial clinical exam $225 $150 $75 33%
Follow-up exam (established patient) $75 $45 $30 40%
Extended consultation (may include charting) $225 $150 $75 33%
Consultation or second opinion (may include charting) $195 $135 $60 31%
Emergency office visit $150 $110 $40 27%
Prophylaxis (when performed by hygienist) $115 - $140 $75 - $100 $40 31%
Prophylaxis (when performed by dentist) $165 $110 $55 33%
Antimicrobial Therapy, Initial Dose $160 $115 $45 28%
Antimicrobial Therapy, Additional Dose $60 $45 $15 25%
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 33%
X-Ray Panorex $125 $85 $40 32%
X-Ray Full Mouth, Including Bitewings (complete) $115 - $165 $85 $60 39%
Extraction (simple) $300 $200 $100 33%
Night Guard (acrylic - laboratory processed) $600 - $700 $450 $200 31%
Processed acrylic temps. $350 $250 $100 29%
Intra-Coronal Resin/Fiberglass Splint (per tooth) $250 $200 $50 20%
Models (if necessary), includes upper & lower $120 $85 $35 29%
White Composite Resin Fillings - Anterior - - - -
White composite resin filling - 1 surface - anterior $175 - $225 $140 $60 30%
White composite resin filling - 2 surface - anterior $235 - $285 $175 $85 33%
White composite resin filling - 3 surface - anterior $385 $285 $100 25%
White composite resin filling - 4 surface - anterior $450 $335 $115 25%
White Composite Resin Fillings - Posterior - - - -
White composite resin filling - 1 surface - posterior $185 - $235 $150 $60 29%
White composite resin filling - 2 surface - posterior $245 - $295 $185 $85 31%
White composite resin filling - 3 surface - posterior $385 $285 $100 25%
White composite resin filling - 4 surface - posterior $450 $335 $115 25%
Bonding Note: In some cases bonding is used for relatively small repairs and in other cases a larger portion of tooth surface is involved. Fees will vary accordingly and Network savings will be in the range of 33% for all bonding procedures.        
Bonding, per tooth $350 - $700 $200 - $550 $175 33%
Note: Fees vary for some procedures, as shown, based upon materials, lab fees, and other professional considerations. Dentist will confirm UCR fee and variables, if any, upon request. - - - -
Cosmetic Procedures: - - - -
Diagnostic Waxup (treatment planning and aesthetic workup) $2000 $1750 $250 12%
Porcelain Laminate Veneer $1400 - $1700 $1100 - $1325 $338 22%
Porcelain Inlay (including composite temp.) $1550 $1150 $400 26%
Cosmetic Tooth Whitening: Includes Oral Exam, Two office visits, Full mouth impressions and models, Whitening trays, All materials, At home application of whitening material (See exam* and prophylaxis notes below.)  $350 - $500 $275 $150 35%
Cosmetic Tooth Whitening: Accelerated tooth whitening procedure using high intensity light, includes one or more office visits, Oral Exam, All materials. (See exam* and prophylaxis notes below.) $450 - $550 $325 $175 35%
Cosmetic Tooth Whitening: Accelerated tooth whitening procedure using high intensity light, includes one or more office visits, Oral Exam, All materials. (See exam* and prophylaxis notes below.)
Alternate Fee - Certain Manhattan Locations Only - Please consult with your dentist.
$550 - $650 $375 $225 37%
Cosmetic Tooth Whitening: Accelerated tooth whitening procedure using high intensity light, includes one or more office visits, Oral Exam, Full mouth impressions and models, Whitening Trays, All materials for at-home follow up. Combines office and take-home procedures shown above. (See exam* and prophylaxis notes below.) $650 - $800 $500 - $550 $200 28%
*Tooth Whitening/Bleaching exam notes: Your dentist must determine that teeth and gums are in suitable conditon, and which process may be most appropriate, prior to cosmetic tooth whitening. If prophylaxis has not been performed recently, your dentist may require same. The additional fee for prophylaxis, if necessary, will be the adult or child prophylaxis fee shown on this schedule. - - - -
Crowns and Fixed Bridgework: - - - -
Crown (Porcelain fused to High Noble Metal) $1400 - $1800 $1250 - $1500 $225 14%
Crown, per tooth if fixed bridge $1400 - $1800 $1250 - $1500 $225 14%
All Porcelain Crown $1600 - $2100 $1350 - $1600 $375 20%
Cad-Cam Crown $1650 - $2150 $1400 - $1650 $375 20%
Gold Onlay $1400 - $1800 $1250 - $1500 $225 14%
Porcelain Onlay $1750 $1250 - $1500 $375 21%
Provisional (temporary) Crown
interim short-term restoration
$350 $225 $125 36%
Post and Core (Prefab.) $450 $350 $100 22%
Post and Core (Cast) $700 - $750 $550 $157 24%
Implants: - - - -
Implant (Surgical Fee) does not include prosthetics (Crown) $2300 - $2500 $1500 - $1750 $775 32%
Implant Supported Crown (does not include abutment) $1500 - $1800 $1350 - $1450 $250 15%
*Abutment for implant supported crown may be custom or prefab depending upon details of each case. Cost will vary based upon degree of difficulty and time and materials and lab charges, if applicable. Please ask your dentist about UCR so that you can determine savings in network. - - - -
Custom *Abutment in addition to Crown $550 - $1050 $450 - $950 $100 12%
Prefab *Abutment in addition to Crown $450 - $750 $300 - $450 $225 37%
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%
Dentures: - - - -
Lab hard reline (per arch) $1000 - $1250 $800 - $950 $250 22%
Complete Denture (per arch) $2800 - $3600 $2000 - $2600 $800 26%
Transitional Partial Denture (lab processed) $1700 $1300 - $1500 $300 18%
Interim Partial Denture (flipper) $850 $650 $200 24%
Semi-Precision Partial Denture $3000 - $4000 $2000 - $3000 $1000 29%
Clasp Partial Denture $2500 - $3500 $2000 - $2500 $750 25%
Note: Implant Supported Bar Overdenture - please consult with dentist due to variation in treatment and professional fees associated with this procedure - - - -
Implant Supported Bar Overdenture (consult with dentist) $10,000 $8,000 $2000 20%
 

 
*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.