Service Listing
D0120 Periodic oral evaluation- established patient $$55.00
D0150 Comp Oral Eval-New or estab. Patient $87.00
D0140 Limited Oral Evaluation $81.00
D0220 Intraoral- periapical first image $32.00
D0210 Complete Series X-rays $ 137.00
D0274 Bitewings 4 $67.00
D1110 Prophy Adult $101.00
D1120 Prophy Child $73.00
D2740 Crown- Porcelain/ceramic $1270
D2752 Crown- Porcelain fused to noble metal $1141.00
D2950 Core Buildup $281.00
D7140 extraction erupted tooth $190.00
D7210 surgical extraction $301.00
D2392 Composite 2 surface Posterior $ $283.00
D2391 Composite 1 surface Posterior $ 181.00