General Dentistry: 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.

This schedule shows network fee reductions. Adjusting for periodic updates, member savings should range from approximately 20% to 60%. We have tried to secure exceptional savings on preventive and diagnostic services, including cleaning, oral exams and x-rays. We hope these rates will give NYDN members more regular access to oral exams and preventive care. To verify network savings, ask the dentist about his or her usual fee for services rendered. If members or participating dentists have questions about rates, procedures or any network matter, please feel free to contact us.


Dentists: Please Verify Member Status at each member visit.
General Dentistry Rates & Procedures Regional Fee Network Fee Typical Network Savings Typical % Savings
Diagnostic-Preventive Visit: Oral Exam and Prophylaxis (cleaning)
Member pays flat fee per visit of $65 - Unlimited utilization for single members and all covered household members. 		$125 - $175 $65 $85 57%
Extended Diagnostic-Preventive Visit, Oral Exam + Prophylaxis (cleaning) + Full - Mouth X-Rays, including complete bite wings or Panorex Study
Member pays flat fee per visit of $140 - Unlimited utilization for single members and all covered household members. 		$250 - $355 $140 $162 54%
Periodic Oral Evaluation $45 - $55 $25 $25 50%
Comprehensive Oral Evaluation $65 - $95 $45 $35 44%
Periapical X-ray $25 $10 $15 60%
X-Ray Bite Wings (4 - complete) $55-$75 $40 $25 38%
X-Ray Panorex $110 - $165 $75 $62 45%
X-Ray Full Mouth, Including Bitewings (complete) $100 - $160 $75 $55 42%
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 - Adult $80-$140 $65 $35 41%
Prophylaxis - Child $75 $50 $25 33%
Full mouth debridement/scaling $250 $150 $100 40%
Scaling per quadrant/extended $150-$200 $80 $95 54%
Chemotherapeutic agent (per tooth or site) $65 - $90 $45 $22 42%
Chemotherapeutic agents, per quadrant $160 - $220 $115 $75 40%
Bacterial Study (microscopic) $25 $20 $5 20%
Fluoride application - Child $55 - $65 $30 $30 50%
Sealant (occlusal surface) per tooth $55 $35 $20 36%
Desensitizing (per quad) $60 - $75 $50 $18 26%
Night Guard (rubber) $300 - $450 $235 $140 37%
Night Guard (acrylic - laboratory processed) $600 - $700 $450 $200 31%
Single tooth extraction (simple) $160 $105 $55 34%
Single tooth extraction (surgical) $300 - $425 $185 $177 49%
Intra-Oral Incision and Drainage of Abcess $250 - $400 $175 $150 46%
Silver Amalgam Fillings - - - -
Silver Amalgam filling - 1 surface $100 - $140 $75 $45 37%
Silver Amalgam filling - 2 surface $150 - $225 $115 $72 39%
Silver Amalgam filling - 3 surface $200 - $250 $155 $70 31%
Note: Replacement of old or lost fillings with white resin material will be billed as shown below. Actual cost of the procedure will depend on number of tooth surfaces affected by the new procedure.        
White Composite Resin Fillings - Anterior - - - -
White composite resin filling - 1 surface - anterior $100 - $170 $85 $60 39%
White composite resin filling - 2 surface - anterior $150 - $200 $120 $55 31%
White composite resin filling - 3 surface - anterior $220 - $300 $165 $95 37%
White composite resin filling - 4 surface - anterior $350 $275 $75 21%
White Composite Resin Fillings - Posterior - - -
White composite resin filling - 1 surface - posterior $130 - $180 $100 $55 35%
White composite resin filling - 2 surface - posterior $175 - $225 $130 $70 35%
White composite resin filling - 3 surface - posterior $225 - $325 $170 $105 38%
White composite resin filling - 4 surface - posterior $350- $450 $275 $125 32%
Bonding Note: Bonding utilizes white composite resin, with special attention to cosmetic considerations. 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 (see notes above - fees will vary depending on extent of bonding required) $450 $300 $150 33%
Note on Crowns: A typical crown procedure includes three office visits to prepare the tooth, take impressions, install temporary crown, and install permanent crown. In some cases, fees shown for crowns may vary by 10% to 15% due to lab fees and material cost, including the cost of gold. To determine member savings, please ask your dentist to confirm his/her UCR fee. Please see separate fees for post and core, sometimes needed in addition to crown. - - - -
Crown - porcelain fused to high noble metal $900 - $1300 $775 $325 25%
Crown - porcelain fused to high noble metal
Alternate Fee - Certain Manhattan Locations Only - Please consult with your dentist.		 $1000 - $1500 $850 $400 32%
Crown - porcelain fused to semi-precious metal $800 - $1150 $675 $300 31%
Crown - porcelain/ceramic substrate $1100 - $1500 $875 $425 33%
Crown - porcelain/ceramic substrate
Alternate Fee - Certain Manhattan Locations Only - Please consult with your dentist.		 $1200 - $1600 $925 $475 34%
Crown - Recement Crown $65 - $80 $45 $25 35%
Prefab. post and core (in addition to crown) $350 $270 $80 23%
Cast post and core (in addition to crown) $450 $350 $100 32%
Core Buildup (strengthen core for crown application) $325 - $375 $235 $115 33%
*Crown Abutments: for implant supported crown may be custom or prefab depending upon details of each case. Cost will vary based upon degree of difficulty, time, 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 $300 - $950 $175 22%
Prefab *Abutment in addition to Crown $450 - $750 $250 - $450 $250 46%
Implants: - - - -
Dental Implant
(Surgical Fee) Does not include Crown or Abutment		 $1600 - $2200 $1400 $500 26%
Implant Supported Crown (does not include abutment) $900 - $1300 $775 $325 25%
Flipper $500 $400 $100 20%
Root Canal Therapy - Anterior $550 - $750 $450 $200 31%
Root Canal Therapy - Bicuspid $725 - $925 $575 $225 31%
Root Canal Therapy - Molar $800 - $1200 $650 $350 35%
Root Canal Therapy - Molar
Alternate Fee - Certain Manhattan Locations Only - Please consult with your dentist.		 $800 - $1350 $750 $325 30%
Dentures: Some dentures can be completed in two visits and other dentures will require five or six visits. Please consult with your dentist about variations in cost, materials (acrylic or custom) and time required for each procedure. - - - -
Interim Partial Denture (Temporary Denture) $750 $600 $150 20%
Repair of Partial Denture $200 - $275 $150 $87 37%
Relining Dentures (Chairside - Both Arches) $350 $200 - $250 $125 36%
Relining Dentures (Lab Processed - Both Arches) $450 $350 $100 32%
Note: Cost for Implant Overdenture will vary based upon time and materials. Please consult with your dentist about this item and note that member cost will be approximately 26% lower than the UCR fee normally charged by the dentist for same procedure.        
Implant Overdenture (Complete - Per Arch) $2000 - $3000 $1450 - $2250 $650 26%
Partial Denture (Metal Base with Saddles) $1250 - $1400 $900 - $1000 $375 28%
Full Denture (Acrylic - Per Arch) $950 - $1650 $700 - $1000 $450 35%
Full Denture (Custom Materials and Lab Work - Per Arch) $1400 - $1800 $1200 $400 25%
Fixed Bridge Pontic (Replaces Missing Tooth) $900 - $1200 $725 - $975 $225 21%
Fixed Bridge Abutment (Crown) $900 - $1300 $775 $325 25%
Labial Veneer (Resin Laminate - Chairside) $475 $300 $175 36%
Veneers: In some cases, Lab fees for Porcelain Veneers may increase network rate shown by 10% to 15%. Dentist will confirm UCR fee and variables, if any, upon request. - - - -
Labial Veneer (Porcelain Laminate - incl. Lab Fees) $950 - $1250 $825 $275 25%
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%
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 $300 $200 40%
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 $325 $275 46%
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. - - - -

*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.