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| Code | Service | Fee |
|---|---|---|
| D0120 | Periodic oral evaluation - established patient | $55.00 |
| D0150 | Comp oral eval - new or established 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 | $1,270.00 |
| D2752 | Crown - porcelain fused to noble metal | $1,141.00 |
| 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 |
Call now or fill out this form to connect with one of our friendly staff members.