|
Porcelain Crown
|
$65
|
| Package Name |
|
| Composturas porcelain (per piece) |
$65
|
| Metal porcelain fixed bridge (per piece) |
$216
|
|
|
Dental X Ray
|
$5
|
| Package Name |
|
| Full Series periapical periodontal |
$27
|
| Lateral and frontal cephalometric skull |
$16
|
| Periapical, occlusal dental radiographs |
$5
|
|
|
Veneers
|
$103
|
| Package Name |
|
| Composite Veneers |
$103
|
| Porcelain Veneers |
$206
|
|
|
Ceramic Crown
|
$433
|
| Package Name |
|
| Ceramic crown, type in Ceram, Procera, Empress (per unit) |
$433
|
|
|
Root Canals
|
$38
|
| Package Name |
|
| Endodoncias Birradiculares |
$119
|
| Endodoncias multirooted |
$151
|
| Endodoncias uniradicular |
$103
|
| Open (No shutter) |
$38
|
| Reendodoncias |
$173
|
| Root amputation Therapeutics (Hemisection) |
$70
|
| Root canals of deciduous teeth |
$65
|
| Scaling and Root Planing |
$43
|
|
|
Gingival Flap Surgery
|
$54
|
| Package Name |
|
| Apical reposition flap |
$292
|
| Flap surgery (per tooth) |
$54
|
| Modified Widman |
$216
|
|
|
Dental Braces
|
$8
|
| Package Name |
|
| Composure in mobile or fixed appliances |
$43
|
| Renovation mobile appliances for loss or breakage |
$97
|
| Replacement of aesthetic brackets (unit) |
$11
|
| Replacement of metal brackets (unit) |
$8
|
| Replacement of self-ligating brackets and metal Tip-Edge (unit) |
$11
|
| Sapphire replacement brackets |
$16
|
|
|
Splints
|
$38
|
| Package Name |
|
| Home tooth whitening (includes kit, splints and reviews) |
$222
|
| Mandibular advancement splint |
$303
|
| Retaining plates, or splint hawley |
$108
|
| Soft splint |
$87
|
| Splint therapy discharge rate Michigan |
$216
|
| Splinting of teeth (per tooth) |
$38
|
| Splinting of teeth (sextant) |
$162
|
|
|
Extractions
|
$27
|
| Package Name |
|
| Extractions |
$27
|
| Removing tailpiece not included |
$65
|
| Surgical removal (tailpiece, including any part, root fragments) per piece |
$97
|
|
|
Pulpotomy
|
$76
|
| Package Name |
|
| Pulpotomy |
$76
|
|
|
Sinus Treatment
|
$541
|
| Package Name |
|
| Sinus Lift |
$541
|
|
|
Endodontist
|
$70
|
| Package Name |
|
| Endodontics in primary teeth |
$70
|
| Endodontics in primary teeth (pulpectomy) |
$76
|
|
|
Dental Crowns
|
$32
|
| Package Name |
|
| Acrylic Temporary crown |
$43
|
| Cast core (corona separately) |
$108
|
| Crown Lengthening |
$216
|
| Fixed space maintainer |
$87
|
| Metal casting crown |
$65
|
| Paste crowns or bridges |
$32
|
| Porcelain crowns metal |
$216
|
|
|
Dental Bridges
|
$216
|
| Package Name |
|
| Maryland Bridge |
$325
|
| Metal porcelain fixed bridge |
$216
|
| Metal-ceramic bridge, type in ceram, procera, empress |
$292
|
| Zirconium fixed bridge |
$379
|
| Zirconium fixed bridge (per piece) |
$541
|
|
|
Dental Implants
|
$54
|
| Package Name |
|
| Implant study |
$162
|
| Metal Implants |
$411
|
| Microimplants |
$130
|
| Reimplantation pieces |
$54
|
| Treatment Periimplantitis |
$65
|
|
|
Dental Sealant
|
$8
|
| Package Name |
|
| Occlusal Sealants |
$8
|
|
|
Periodontitis Treatment
|
$54
|
| Package Name |
|
| Periodontal |
$65
|
| Periodontal maintenance (Arcade) |
$54
|
|
|
Gingivitis Treatment
|
$216
|
| Package Name |
|
| Free gingival graft |
$216
|
|
|
Zirconia Crown
|
$541
|
| Package Name |
|
| Zirconium crown (per piece) |
$541
|
|
|
Gum Surgery
|
$76
|
| Package Name |
|
| Partial gingivectomy |
$76
|
|
|
Fillings
|
$27
|
| Package Name |
|
| Amalgam Filling |
$38
|
| Composite seals |
$43
|
| Coronary Reconstruction |
$87
|
| Direct or indirect pulp capping |
$27
|
| Direct or indirect pulp capping |
$32
|
| Pins coronary reconstruction, Poles, Bolts |
$92
|
| Porcelain Inlay |
$141
|
| Restoration of Angles |
$52
|
|
|
Orthodontics
|
$1,839
|
| Package Name |
|
| Fixed Orthodontic Treatment with low friction aesthetic brackets (Self-ligating and Tip-Edge per arch) |
$811
|
| Fixed orthodontic treatment with metal brackets low friction (Self-ligating and Tip-Edge per arch) |
$649
|
| Fixed orthodontic treatment with metal brackets Minis (per arch) |
$487
|
| Fixed retention tongue (sextant) |
$162
|
| Fixed space maintainer |
$70
|
| Fixed space maintainer (Unilateral) |
$87
|
| Invisible Orthodontics Treatment |
$1,839
|
| Orthodontic treatment Fixed Brackets aesthetic ceramics (arcade) |
$649
|
| Orthodontic treatment Fixed Sapphire Brackets (per arch) |
$811
|
| Orthodontic treatment with mobile appliances (by arch) |
$541
|
| Periodic visits Invisible Orthodontics Review |
$141
|
| Studio Invisible Orthodontics |
$433
|
|
|
Teeth Bleaching
|
$411
|
| Package Name |
|
| Office tooth bleaching (laser, plasma lamp ...) |
$411
|
|
|
Dentures
|
$325
|
| Package Name |
|
| Complete removable prosthesis (lower top) |
$920
|
| Full removable prosthesis (upper or lower) |
$487
|
| Removable partial denture acrylic, 11 pieces in future Total (including hooks or retainers) |
$487
|
| Removable partial denture acrylic, 7-10 parts Total (including hooks or retainers) |
$433
|
| Removable partial denture acrylic, up to 6 pieces Total (including hooks or retainers) |
$325
|
|
