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Fee Disclosure

Fee Discolsure 2022

LAKEWOOD

  1. D6010 Surgical place implant: $2150
  2. D4260 Osseous Surgery 4+ per quad/D4261 Osseous surgery 1-3 quad: $1255/Quad or $1090/Quad
  3. D4910 Periodontal maintenance: $162
  4. D0140 Limited oral evaluation: $175
  5. D7953 Bone Repl Grft Ridge prsv/site: $495
  6. D4273 Connective tissue graft: $965
  7. D4277 Free soft tissue graft: $905
  8. D7210 Extract, erupted tooth: $355
  9. D0364 CT Capture, Limited View: $365
  10. D0180 Comprehensive Perio Evaluation: $230
  11. D3330 Endo Therapy- Molar: $ 1405
  12. D4341/ D4342 Perio Scale/Root Pln 4+ per quad/ Perio Scale/Root Pln 1-3th quad: $255/quad or $165/quad
  13. D4263 Bone replace graft: $710
  14. D4249 Clinic crown lengthen-hard tissue: $905
  15. Periodic oral evaluation: $95

FRISCO

  1. D6010 Surgical place implant: $2150
  2. D3330 Endo Therapy- Molar: $ 1405
  3. D4260 Osseous Surgery 4+ per quad/D4261 Osseous surgery 1-3 quad: $1255/Quad or $1090/Quad
  4. D0140 Limited oral evaluation: $175
  5. D7953 Bone Repl Grft Ridge prsv/site: $495
  6. D0364 CT Capture, Limited View: $365
  7. D4273 Connective tissue graft: $965
  8. D7210 Extract, erupted tooth: $355
  9. D3348 Retreat: $1650
  10. D0180 Comprehensive Perio Evaluation: $230
  11. D4277 Free soft tissue graft: $905
  12. D4910 Periodontal maintenance: $162
  13. D4341/ D4342 Perio Scale/Root Pln 4+ per quad/ Perio Scale/Root Pln 1-3th quad: $255/quad or $165/quad
  14. D7952 Sinus Augment: $950
  15. D4263 Bone replace graft: $710

The health care price listed for any given health care service is an estimate. Actual charges for the health care service are dependent on the circumstances, including any complications or exceptional treatment, at the time the service is rendered.

If you are covered by health insurance or a dental plan, you are strongly encouraged to consult with your insurer or plan to determine accurate information about your financial responsibility for a particular health care service provided by a health care provider at this office. If you are not covered by health insurance or a dental plan, you are strongly encouraged to contact our billing office at [insert telephone number] to discuss payment options prior to receiving a health care service from a health care provider at this office since posted health care prices may not reflect the actual amount of your financial responsibility.