Services

(00000) Copying of X-Rays $6
(00001) Perio Guard $24
(00002) Perio Med $30
(00003) RX-Oxygene Mouthrinse $23
(00004) RX-Hygiene Kit $67
(00005) RX-Braun Oral B 3D $112
(00006) Myoloc $194
(00007) Bleaching Tube (One Tube Only) $30
(00008) Periomed & Cavity Shield $36
(00009) Remake Temp Crown/Bridge $69
(00010) Gel Foam 1st Piece $30
(00011) Gel0Foam Additional $18
(00012) Recement Post $65
(00013) Study Model $112
(00014) Replace Teeth / Acrylic on Max $522
(00015) Crown Repair $51
(00016) IRM Build-up $142
(00020) Remake Bridge-Lab Cost $271
(00021) Tooth Brush (Sonicare) Oral B $57
(00022) C0-Pay $13
(00023) O-Ring Replacement $26
(00025) Removal of Cropwn / Bridge $142
(00026) Evaluation $58
(00038) Drain tooth ache $93
(00042) Tongue Cleaner $14
(00043) Control RX- 2 tubes/ Clinpro 5000 $47
(00044) Fluoride – For Kids .04% $23
(00046) Stent Impression $57
(00050) Biotene – Dry Mouth ToothPaste $10
(00055) RX- Mouthwash $9
(00059) Biotene- Denture Grip $9
(00062) Bracket Removal $194
(00063) Temp Filling $60
(00067) Temp Repair of Partial and Denture $239
(00068) Dry Socket $26
(0007) Bleaching Tube (2 Tubes) $57
(00071) Crown-Interm-Temp $211
(00072) Copings $615
(00074) Hader Bar $825
(00075) Flipper (interim maxillary complete) $679
(00076) Recement or Rebod inlay, Onlay $88
(00077) Connector Bar $615
(00078) Section Off Bridge $142
(00079) Just for Kids $17
(00080) Vanish – Kids $35
(00081) Bleaching U/L & Control RX $293
(00082) Periomed & Control RX $29
(00087) Perio Splint with Wire Mesh $927
(00093) Sonicare – Air-Floss Pro $64
(00094) ZOOM Whitening Pen $20
(00095) ZOOM BreathRX Kits $20
(00096) Sonicare EasyClean $64
(00099) Reinforcement Fee $204
(00104) Reline Lynol $168
(00110) Initial Oral Exam $39
(00111) Remake Crown / Difference $468
(00120) Periodic Oral Eval Established Patient $31
(00123) Braun Oral-B Plaque Remover $11
(00130) ER Visit $43
(00140) Evaluation- Problem Focused $58
(00150) Comprehensive Oral Eval $58
(00160) Detail & Extent Oral Eval Problem Focused $68
(00170) Re-Evaluation Limited Problem $65
(00180) Comp Periodontal Eval $76
(00210) Intraoral Complete Including Bite $116
(0022) Perio Med & Control RX $36
(00220) Periapical First Film Intraoral $29
(00222) Invisalign Consult & Pictures $231
(00223) Invasalign Cleaning System $57
(00225) Clinpro 5000 $27
(00230) Periapical – each additional X-Ray $27
(00231) Lab Fee on Implant Dentures $1,784
(00232) Dr Fee on Implants $1,740
(00233) Peridex Small Bottle $14
(00234) Peridex $30
(00240) Single Film $15
(00250) Single 2nd Film $17
(00260) additional Film $15
(00270) Bitewings – 1 Xray Image $32
(00272) Bitewing – 2 Xray images $39
(00273) Bitewings – 3 Xray Images $47
(00274) Bitewing – 4 Xray images $60
(00330) Panoramic Xray Image $130
(00365) Sulcus Sterilization Perio Treatment $83
(00415) Bacteriologic Studies  $200
(00431) Velscope Mucosal Abnormalities $35
(00444) Lab cost of Implants $3,118
(00460) Pulp Vitality Tests $32
(00470) Diagnostic Casts $54
(0052) Soft Liners $335
(00530) Soothe RX Sensitive Teeth Med. $55
(00560) Rembrant Sensitivity Toothpaste $15
(00896) Snoring Device – Glidewell $711
(00995) Remove the Brackets $168
(01063) Combination Appliance $725
(01076) Space Maintainer – Fixed Bilateral $852
(01093) Schwarz Appliance (upper) $997
(01094) Schwarz Appliance (lower) $997
(01110) Prophylaxis – Adult $79
(01116) Vivera Retain per Arch $290
(01120) Prophylaxis – Child $65
(01162) Retainer 1 Arch $230
(01201) Fluoride – Child  Cavity & Shield $35
(01204) Fluoride – Topical Application $48
(01205) Fluoride – Adult $38
(01206) Topical Application / Fluoride VA $45
(01208) Topical Application / Fluoride EX $49
(01236) Denture Brush $6
(01254) Perio Chip $30
(01351) Sealant per Tooth $40
(01510) Space Maintainer – Fixed Unilateral $515
(01515) Space Maintainer – Fixed Bilateral $761
(01520) Space Maintainer – Removable Unilateral $468
(01525) Space Maintainer – Removable Bilateral $427
(01550) Re-Cement or Re-Bond Space $57
(01563) Temp Bridge $782
(01999) Additional Routine Prophy / Clean $26
(02053) Diastema Closing – Jackscrew App $420
(02110) Amalgram 1 Surface Primary $99
(02112) Tongue Fence $561
(02114) Hay Rake – Thumb Sucking Appliance $502
(02120) Amalgam 2 Surface Primary $114
(02130) Amalgam 3 Surface Primary $135
(02131) Amalgam 4 Surface or more $180
(02140) Amalg 1 Surface, Primary or $118
(02150) Amalg 2 Surface Primary or $221
(02160) Amalg 3 Surface, Primary or $256
(02161) Amalg 4 Surface or more, Primary or $289
(02222) Bonding – Splinting $219
(02223) Bleaching / Zoom $430
(02330) Resin – Composite 1 Surface $222
(02331) Resin – Composite 2 Surfaces $256
(02332) Resin – Composite 3 Surfaces $335
(02335) Resin – Composite 4 or more Surfaces $357
(02356) Attachments – Cap $70
(02380) Composite Posterior Primary 1 $122
(02381) Composite Posterior Primary 2 $143
(02382) Composite Posterior Primary 3 $155
(02385) Composite Posterior 1 Surface $123
(02386) Composite Posterior 2 Surfaces $155
(02387) Composite Posterior Permanent $211
(02391) Resin Composite 1 Surface $235
(02392) Resin Composite 2 Surfaces $280
(02393) Resin Composite 3 Surfaces $357
(02394) Resin Composire 4 or more Surfaces $390
(02510) Inlay- Metallic 1 Surface $774
(02520) Inlay – Metallic 2 Surfaces $838
(02530) Inlay – Metallic 3 or more Surfaces $1,072
(02542) Onlay – Metallic 2 Surfaces $640
(02543) Onlay – Metallic 3 Surfaces $1,072
(02544) Onlay – Metallic 4 or more Surfaces $844
(02610) Inlay Porcelain / Ceramic 1 Surface $750
(02620) Inlay Porcelain / Ceramic 2 Surfaces $755
(02630) Inlay Porcelain / Ceramic 3 or more Surfaces $886
(02642) Onlay Porcelain / Ceramic 2 Surfaces $797
(02643) Onlay Porcelain / Ceramic 3 Surfaces $812
(02644) Onlay Porcelain / Ceramic 4 or more Surfaces $968
(02650) Inlay Resin BasedComposite 1 Surface $345
(02651) Inlay Resin BasedComposite 2 Surfaces $396
(02652) Inlay Resin BasedComposite 3 or more Surfaces $465
(02662) Onlay Resin Based Composite 2 Surfaces $416
(02663) Onlay Resin Based Composite 3 Surfaces $485
(02664) Onlay Resin Based Composite 4 or more Surfaces $543
(02740) Crown-Por / Ceramic or Empress Surface $1,338
(02750) Crown-PFG-Gold / Captek $1,366
(02751) Crown-PFM-Base Metal $937
(02752) Crown-PFM- Noble Metal $837
(02780) Crown 3/4 Gold High Noble Metal $1,007
(02790) Crown Gold CRN $1,366
(02791) Crown Full Cast Predominantl $644
(02792) Crown (all metal) $681
(02810) Crown 3/4 Cast Metal $884
(02910) Recement / Rebond Inlay, Onlay, Vei $88
(02915) Recement / Rebond Indirect/Pref $65
(02920) Recemenet or Rebond Crown $88
(02930) Pref Stainless Steel Crwon Prim $360
(02931) Prefab Stainless Steel Cr. $326
(02933) Prefab Resin Crown $404
(02933) Prefab Stainless Steel CR Resin $398
(02940) Protective Restoration $86
(02950) Core Build-up, Including any Pins $297
(02951) Pin-Per Tooth $88
(02952) Post/Core Inadd to Crown $314
(02953) Add Indirectly Fab Post on Same $573
(02954) Pref Post and Core in Add $314
(02955) Post Removal – No Endo Therapy $140
(02960) Labial Veneer – Resin Laminate – Cha $398
(02961) Labial Veneer – Resin Laminate – Lab $948
(02962) Labial Veneer – Porcelain Laminate $1,495
(02970) Crown Temp – Fractured Tooth $647
(02975) Coping $978
(02980) Crown Repair, By Report $99
(03110) Pulp Cap-Direct (Ex. Final Rest) $146
(03120) Pulp Cap-Indirect (Ex. Final Rest) $146
(03220) Therapeutic Pulp (Excluding Final) $146
(03221) Pulp DeBridgement – Primary $160
(03230) Pulp Therapy – Anerior Primary $167
(03240) Pulp Therapy – Posteror, Prime $238
(03310) Root Canal – Anterior $792
(03320) Root Canal – Bicuspids $877
(03330) Root Canal – Molar $962
(03346) Retreat of Prev Root Canal – Anterior $757
(03347)  Retreat of Prev Root Canal – Bicuspids $858
(03348)  Retreat of Prev Root Canal – Molar $947
(03350) Apexification $114
(03351) Apexification – Initial Visit $150
(03352) Apexification – Recalcification $250
(03410) Apiocoetomy / Surgery – Ant $889
(03421) Apiocoetomy / Surgery – Bicuspid $997
(03425) Apiocoetomy / Surgery – Molar $1,227
(03430) Retrograde Filling – Per Root $91
(03450) Amputation of Root – Per Root $234
(03460) Endodontic Endosseous Implant $250
(03530) Metal Framework $177
(03920) Hemiseciton, Excl Root Canal $369
(03960) Bleaching External Per Arch $106
(04110) Perio Eval and Treatment $50
(04210) Gingivectomy / Gingivoplasty – P $694
(04211)  Gingivectomy / Gingivoplasty – Tooth $306
(04220) Gingival Curettage, Surgical, Pe $146
(04240) Gingival Flap procedure, Incl root $298
(04241) Ging Flap 1-3 Teeth – Including Root $152
(04249) Crown Lengthening – Hard Tissue $502
(04250) Surgical – Mucogingival – Per Quad $927
(04260) Osseous Surgery – Per Quad $775
(04263) Bone Graft – 1st Site in Quad $207
(04264) Bone Graft Replacement – Each Additional $207
(04265) Osseous Surgery $547
(04273) Tissue Graft per Tooth Subepith $638
(04274) Distal or Proximal Wedge $166
(04320) Provisional Splinting – Intracoro $390
(04321) Splinting – Extracoronal $450
(04341) RPC- Periodontal Scaling and Root $197
(04342) RPC 1-3 Teeth per Quad $104
(04345) Perio Scaling / Presence – Inflamed $104
(04355) Full Mouth Debridement for Per $98
(04381) Arestin / Perio Chip $44
(04910) Periodontal Maintenance $94
(05110) Upper Denture $930
(05120) Lower Denture $930
(05130) Immediate Upper Denture $1,346
(05140) Immediate Lower Denture $1,346
(05211) Upper Partial – Acrylic $898
(05212) Lower Partial – Acrylic Base $898
(05213) Upper Partial – Cast Metal, RES Base $1,178
(05214) Lower Partial – Cast Metal Res Base $1,249
(05225) Upper Valplast – Hybrid – polymers $1,539
(05226) Lower – Hybrid, Polymers / Valplast $1,539
(05281) Unilateral Partial Denture Remo $1,630
(05410) Upper Denture Adjustment $34
(05411) Lower Denture Adjustment $34
(05421) Upper Partial Adjustment $34
(05422) Lower Partial Adjustment $34
(05510) Repair Broken Denture Base $170
(05520) Replace Missing or Broken Tooth $85
(05610) Repair Resin Denture Base $114
(05620) Repair Cast Framework $256
(05630) Repair or Replace Broken Clasp $241
(05640) Replace – Partial Teeth – Per Tooth $129
(05643) Pulsonic oral B Toothbrush $57
(05650) Add Tooth to Existing Partial Denture $162
(05660) Add Clasp to Existing Denture $239
(05671) Replace Teeth / Acrylic – Mandibula $574
(05710) Rebase Complete Upper Denture $603
(05711) Rebase Complete Lower Denture $603
(05720) Rebase Upper Partial Denture $603
(05721) Rebase Lower Partial Denture $603
(05730) Reline Upper Denture (chair) $241
(05731) Reline Lower Denture (chair) $190
(05740) Reline Upper Partial (chair) $190
(05741) Reline Lower Partial (chair) $190
(05750) Reline Complete Upper (lab) $267
(05751) Reline Lower Denture (lab) $267
(05760) Reline Upper Partial (lab) $271
(05761) Reline Lower Partial (lab) $271
(05810) Interim Complete Denture – Upper $786
(05811) Interim Complete Denture – Lower $786
(05820) Interim Partial Denture – Upper $675
(05821) Interim Partial Denture – Lower $675
(05850) Tissue Conditioning Soft Reline $165
(05851) Tissue Conditioning Soft Reline $165
(05860) Overdenture – Complete, By Report $1,232
(05861) Overdenture – Partial, By Report $1,232
(05862) Precision Attachment, by Report $682
(05863) Upper Over Denture Complete $1,162
(05864) Upper Over Denture – Partial $1,162
(05865) Lower Overdenture Complete $1,162
(05866) Lower Over Denture Partial $1,162
(05867) O-Rings Replacement $60
(05899) Unspecified Removable Prosthod $43
(05929) Facial Prothehesis $968
(05987) Splint Commissure  $390
(05988) Splint Surgical $390
(06010) Implant Bicon / Anklylos Step 1 $1,238
(06013) Implant Zimmer / Imtec $972
(06053) Implant / Abut Supported Remove $572
(06054) Implant / About Remove Dent Partial $571
(06055) Implant Supported Connecting Bridge $972
(06056) Implant Bicon Step 2 $465
(06058) Implant Bicon Crown Step 3 PFP $696
(06059) Implant – Abutment PFM High  $1,674
(06061) Abutment Supported Porcelain Fused to PF $1,166
(06064) Implant Abutment Cast Metal  $913
(06065) Implant CR Supported Porcelain $1,654
(06066) Implant Anklylos Female Step 2 $1,990
(06070) Implant for Bridge over Implant $756
(06078) Implant Edentulous Arch Over $972
(06079) Implant Edentulos Arch Partial $1,780
(06110) Implant / Abut Upper Denture Rem $944
(06111) Implant/Abut Lower Removable $944
(06192) Lower Removable Acrylic Splint $976
(06193) Upper Removable Acrylic Splint $976
(06210) Pontic Cast High Noble $1,217
(06211) Pontic-Cast Predominatly Base $668
(06212) Pontic-Cast Noble Metal $630
(06240) Pontic/ Implant Bridge PFG $933
(06241) Pontic PFM $900
(06242) Pontic – Porcelain Fused to Noble $630
(06245) Pontic – Porcelain / Ceramic $1,518
(06251) Pontic Resin Predominatly Base $2,054
(06252) Pontic-Resin with Noble Metal $501
(06520) Inlay- Metallic 2 Surfaces $551
(06530) Inlay- Metallic 3 or More Surfaces $704
(06543) Onlay- Metallic 4 Surfaces $634
(06545) Abutment- Maryland Bridge $670
(06549) Retainer- Resin Retainer $860
(06602) Inlay- High Noble Metal 2 Surfaces $886
(06610) Onlay- Gold 2 Surfaces $690
(06740) Abutment Crown- Porcelain / Ceramic $1,518
(06750) Abutment PFG Gold Crown $1,265
(06751) Abutment Crown- PFM $900
(06752) Abutment Crown Fused to Nobel $788
(06790) Abutment Gold Crown $1,118
(06791) Abutment Crown Full Cast Metal $670
(06792) Abutment All Metal Crown $630
(06810) Complex Rehab for Each Unit $153
(06920) Connector Bar $359
(06930) Recement Bridge $134
(06940) Stress Breaker $424
(06950) Precision Attachment / over dent $681
(06972) Prefabricated post and Core $332
(06973) Core Build up for Retainer $332
(06980) Bridge Repair, by Report $70
(06999) Unspecified Fixed Prosthodontic $446
(07110) Extraction $155
(07111) Ext- Coronal Remanants – Baby Tooth $74
(07120) Ext Each Addittional $85
(07130) Ext- Exposed Roots $219
(07140) Ext, Simple Replace Code $162
(07210) Ext Surgical Removal of Erupted $322
(07220) Ext of Impacted Tooth – Soft Tissue $406
(07230) Removal of Impacted Tooth- Partial $207
(07250) Ext of Root Tip $218
(07280) Surgical Access of an Unerupted $322
(07310) Alveoloplasty in Con with Extra $238
(07320) Alveoloplasty not in Con with Extra $287
(07340) Vestibuloplasty- Ridge Extension $1,027
(07430) Excision of Benign Tumer-Lesion $206
(07470) Removal of Exostosis-Maxilla $250
(07510) Incision & Drainage of Abscess $114
(07910) Suture of Small Wound up to 5CM $21
(07953) Bone Replavement / Graft Ridge $454
(07960) Frenulectomy – Separate Procedure $521
(07970) Hyperplastic Tissue $645
(07971) Operculectomypericoronal $160
(07972) Tori Surgical Reduction of FIB $842
(07980) Sialolithotomy $808
(07997) Ortho Removal Includes Reval $146
(07999) Unspecified Oral Surgery – Gel $28
(08030) Limited Ortho – Adolescent Dent $1,674
(08040) Limited Ortho Treat – Adult Dent $525
(08050) Interceptive Ortho- Primary Dent $1,630
(08060) Interceptive Ortho – Transitional $1,488
(08070) Comprehensive Ortho – Transitional $1,550
(08080) Invis. Comprehensive Ortho Adol $3,211
(08090) Ortho Invis Adult Dentition/com $4,872
(08110) Ortho- Therapy – Tooth Guidance $611
(08120) Ortho- Appliance- Tooth Guidance $637
(08210) Removable Appliance Therapy $611
(08220) Thumb Sucking Appliance $989
(08360) Ortho- Therapy- Harmful Habit $946
(08370) Ortho Appliance Harmful Habit $1,175
(08670) Ortho Periodic Treatment – Part 1 $1,476
(08680) Ortho Retainers 1 Set $267
(08690) Ortho Treatment – Alt Billing $1,383
(08999) Ortho Unspecified Procedure $336
(09110) Viroxyn- Palliative EMERGENCY $39
(09120) Sectioning of Bridge $134
(09230) Nitrous Oxide $122
(09241) IV Sedation / Anesthesia $530
(09310) Consultation $45
(09440) Office Visit – After Scheduled  $54
(09653) Temp Crown $196
(09910) Ultra-EZ / Desensitizing Medicament $17
(09911) Vanish Adults / Desensitizing $34
(09940) OCCL Guard / Comfort Splint / Night $550
(09941) Mouthguard (Athletic) $322
(09943) Occlusal Guard Adjustment $48
(09951) Equilibration Occl Adj $367
(09952) Occlusal Adj- Complete $1,168
(09954) Sleep Apnea $1,594
(09974) Bleaching 1 Arch – 1 Tube $239
(09982) ERA Attachments Zest Anchors $340
(09986) Pre Med $5
(09988) Broke Appt Change $27
(09989) Missed Appt $29
(09999) OSHA Charges $7
(11111) Vanish / Control RX / Sooth RX $84
(11112) Vanich & Just for Kids – 6 yrs $39
(11113) Oraqix Antib – Oral Analg, Topical $14
(11114) Vanish $34
(1212) Opalescence Tower Tooth White $9
(12345) Bleaching Rembrandt 1 Hour $558
(12346) Bleaching Rembrandt 5 Days $371
(12456) Control RX 2 tubes $22
(12564) Lock Abutment $124
(1313) Opalescence (4 Box) Tooth White $30
(1414) Opalescence (10 Box) Tooth White $63
(21212) Invis $5,311
(22222) Invisalign – Crystals (4) $2
(33333) Spa Facial Massage $68
(39656) Thera-Spray Breath Spray $6
(44441) Patient Did Not Show $21
(44444) Water Pik $62
(54040) Root of Tooth, NOS $234
(55555) Spa Chair Massage $11
(58632) Vanish and Control RX $38
(66666) Spa Swedish Massage $58
(77777) Spa DeepTissue Full Body $68
(8060) Interceptive Ortho- Transitional $1,478
(88888) Spa Bamboo Sticks $73
(8999) Misc Services (Ortho Adjust) $91
(89999) Seat Bridge Temp $167
(9430) Office Visit $46
(99852) Ball attachments $1,675
(99999) Missed appointment w/out 24hr notice $24
(AVEO) Sleep AVEO / TSD Snoring $413
(BUZZ) Buzz / Snow White, Oral-B Tooth Brush $12
(D0145) Eval for Child under 3 $50
(D0190) Screening of a Patient $27
(D0273) Bitewings 3 Films $38
(D0350) Intra-Oral Photos & Images $19
(D0791) Complicated Suture up to 5CM $167
(D1206) Vanish- Kids- Fluoride $39
(D1208) Fluoride Application – No Varnishing $43
(D1352) Prevenetive Resin restoration $59
(D1555) Removal of Fixed Space Maintained $681
(D1999) Personal Protective Equipment $9
(D2780) Crown- Gold $903
(D2783) 3/3 Crown Porcelain / Ceramic $947
(D2799) Provisional Crown – Lab $179
(D3332) Incomplete Endodontic therapy $168
(D4346) Scaling Gen Moderate / Severe $88
(D4921) Gingival Irrigation – Per Quadrant $58
(D5221) IMM Max Partial Denture- Resin Base $1,428
(D5222) IMM Man Partial Denture – Resin Base $1,428
(D5223) IMM Max Partial Denture Metal $1,428
(D5224) IMM Man Partial Denture Metal $1,428
(D5511) Lower Denture Repair Broken $170
(D5512) Upper Complete Base Repair Broken $170
(D5611) Lower Partial Denture Base Repair $114
(D5612) Upper Partial Denture Base Repair $114
(D5621) Lower Framework Repai cast $256
(D5622) Upper Framework Partial Repair $256
(D5811) Flipper Interim Complete – Mandibul $502
(D5820) Flipper Interim Part / Denture Upper $674
(D5821) Interim Part / Flipper Denture Lower $1,012
(D5876) Denture Add Metal Substructure $336
(D5982) Stent Surgical $335
(D5993) Cleaning & Maint. Of Upper  $43
(D5999) Sleep Apnea – Snore Silent Nite $844
(D6013) Implant Stern Mini Implant $972
(D6048) Abutment Bridge Porcelain $954
(D6055) Connecting Bar for Implants $972
(D6058) Implant Crowns Single $996
(D6059) Implant Step 3 PFG $864
(D6060) Abutment Supported PFM Crown $2,117
(D6062) Implant Abutment Crown Step 3 $1,102
(D6066) Implant Support Crown PFM $1,849
(D6067) Implant Supported Metal Crown $1,990
(D6068) Abut Stage 3 – Ceramic for Implant $1,518
(D6070) Abut / Implant Stage 3 PFM $1,393
(D6078) Implant – Imtec Lower Over Dentures $531
(D6080) Implant Maint $61
(D6091) Housing / Zest Attachment $42
(D6096) Implant Remove Broken Retaining $124
(D6098) Implant Supported Retaine PF $588
(D6100) Implant Removal $322
(D6104) Bone Graft at Time of Implant $454
(D6199) Implant Unspecified $183
(D6548) Abutment – Maryland Bridge – Porcelain $954
(D6970) Cast Post & Core Part of CROV $306
(D6973) Core Built up- Bridge $264
(D6976) Post Cast Additional $505
(D7286) Biopsy of Oral Tissue $363
(D7311) Aveolplasty 1-3 Teeth per Quad $115
(D7410) Excision of Benign Lesion up to 1 $388
(D7471) Removal of Lateral Exostosis $322
(D7910) Suture of Recent Small Wound $167
(D7911) Complicated Suture up to 5CM $167
(D7952) Sinus Augmentation – Vertical $800
(D7955) Bone Repair or Max Soft/Hard Tissue $207
(D7961) Frenectomy Buccal / Labial $522
(D7962) Frenectomy lingual $522
(D8010) Ortho Limited Primary DENT $623
(D8020) Ortho Limited Transitional Dent $623
(D8030) Ortho Limited Adolescent Dent $623
(D8040) Limited Ortho Treatment of Adult $623
(D8080) Ortho Teen Invis Adolescent Dent $3,372
(D8090) Ortho Comprehensive Adult Dent $4,640
(D8220) Ortho Fixed Appliance – Tongue $774
(D8680) Ortho Essix Retainers 2 Sets $210
(D8695) Removal of Fixed Ortho Appliance $210
(D8998) Interproximal $266
(D8999) Ortho Unspecified Procedure $509
(D9220) Anesthesia – Deep Sedation $2,327
(D9911) Desensitizing Resin  – Gluma $75
(D9930) Post- Surgical Treatment $84
(D9932) Cleaning Upper Denture $29
(D9933) Cleaning Lower Denture $29
(D9934) Cleaning Upper Partial $29
(D9935) Cleaning Lower Partial $29
(D9941) Mouthguard FAB of Athletic $550
(D9944) OCCL Guard – Hard Appliance Full $550
(D9945) OCCL Guard – Soft Full Arch $550
(D9946) OCCL Guard – Hard Partial Arch $550
(D9952) OCCL Adjustment Complete $1,169
(D9971) Enameloplasty $58
(D9972) Bleaching – per Arch 1 Tube $34
(D9973) Bleaching 2 Arch – 2 Tubes $265
(D9999) Tongue Scrapper – Metal $21
(EXP) Invisalign Express $3,904
(FLOSS) Floss $5
(IMPLA) Implant Tooth Brush $12
(INV) Fast Braces $3,713
(LOC) Intraoral Camera / Facial Images $13
(KIT) Bleaching Kit – 1 Hour $56
(PERIO) Perio Chip $22
(S7140) Extraction of Supernumeral Tooth $152
(SNORI) Sleep Apnea & Snoring – EMA $602
(SPA) SPA Reflexology (Foot Massage) $34
(SPA 1) SPA Ear Candling $24
(SPA1) SPA Paraffin Dip $5
(SPA10) SPA Massage Hot Stones $78
(SPA11) SPA Massage Essential Oil $11
(SPA12) SPA Massage Relaxing Facial $29
(SPA14) SPA Massage Detox Footbath $33
(SPA15) SPA Tips $13
(SPA16) SPA Therapeutic Massage $62
(SPA17) SPA Raindrop Massage $86
(SPA18) SPA Deep Tissue Massage Full $64
(SPA19) SPA Dead Sea Scrub $64
(SPA2) SPA Swedish Head, Neck & Back $34
(SPA20) SPA Dry Brushing $15
(SPA21) SPA Poltice Pain Management $38
(SPA23) SPA Medical $35
(SPA30) SPA Head, Neck, Shoulder, Foot $34
(SPA33) SPA- Body Brush Treatment $15
(SPA34) SPA on Foot, Paraffin or Vib $15
(SPA4) SPA Half Body Massage $40
(SPA56) SPA Facial Royal Relaxing  $58
(SPA57) SPA Bemer Treatment – Energy $24
(SPA66) SPA Couple Massage Special 1 1/2 $253
(SPA9) SPA Massage Hands and Arms $33
(TAP) Sleep Apnea and Snoring Tap 3 $818
(TEMP) Temp Bridge $213
(TEMPS) Temps. Custom Made Glidewell $247
(X-RAYS) Coping of XRAYS $5
(ZZZZZ) Snorw Guard $78

 

Contact Information:
(352) 746-0330
1 Regina Blvd Beverly Hills, FL 34465