|
Dentures
|
$423
|
| Package Name |
|
| Full Denture Single Arch ( Lucitone Base) |
$423
|
| Full Denture U/L ( Lucitone Base) |
$706
|
| Full Denture U/L (Cr-Co Base) |
$988
|
|
|
Fluoride Therapy
|
$14
|
| Package Name |
|
| Topical Fluoride Application (polishing included)- adult |
$14
|
|
|
Bone Graft
|
$254
|
| Package Name |
|
| Bone graft per quadrant (grafting materials not included) |
$254
|
|
|
Fillings
|
$11
|
| Package Name |
|
| Composite filling per surface – adult |
$23
|
| Composite filling per surface – primary |
$11
|
| Onlay tooth color per unit |
$367
|
|
|
Dental Checkups
|
$14
|
| Package Name |
|
| Initial oral examination and counseling only |
$28
|
| Periodic oral examination |
$14
|
|
|
Gingivitis Treatment
|
$28
|
| Package Name |
|
| Gingivectomy or gingivoplasty per tooth |
$28
|
|
|
Dental Implants
|
$1,270
|
| Package Name |
|
| Generic Type |
$1,270
|
| Sweden and USA Brand names |
$1,976
|
|
|
Dentist Consultation
|
$28
|
| Package Name |
|
| Initial periodontal examination and record |
$28
|
|
|
Child Dentist
|
$6
|
| Package Name |
|
| Pit andFissure Sealant per tooth Child (Baby teeth) |
$11
|
| Topical Fluoride Application (polishing included) – child |
$6
|
|
|
Extractions
|
$23
|
| Package Name |
|
| Extraction of hard tissue impacting tooth with Burs |
$169
|
| Extraction of soft tissue impacting tooth (no hard tissue cutting) |
$141
|
| Extraction requiring flap opening |
$141
|
| Simple extraction with suture, single tooth |
$23
|
|
|
Gingival Flap Surgery
|
$254
|
| Package Name |
|
| Gingival auto-graft per site |
$282
|
| Gingival flap procedure, per quadrant( include root planing) |
$254
|
|
|
Teeth Cleaning
|
$8
|
| Package Name |
|
| Prophylaxis – adult Scaling and Polishing |
$42
|
| Prophylaxis – child (under 12 year old) |
$8
|
|
|
Ceramic Crown
|
$367
|
| Package Name |
|
| All Ceramic Crown |
$367
|
|
|
Veneers
|
$28
|
| Package Name |
|
| Labial veneer-composite (in-house) per tooth |
$28
|
|
|
Root Canals
|
$226
|
| Package Name |
|
| Molar Root Canal |
$339
|
| Premolar Root Canal |
$226
|
|
|
Splints
|
$423
|
| Package Name |
|
| TMJ Examination, Diagnosis, and Treatment with Occlusal Splints |
$423
|
|
