Perfect Teeth Dental Plan | www.perfectteeth.com

Procedure Description Regular Fee Member Cost Savings
Diagnostic & Preventive
Exam $78 $0 100%
Complete X-rays $152 $0 100%
Preventive Cleaning - Adult
(Limited to two cleanings per year)
$90 $40 56%
Preventive Cleaning - Child
(Limited to two cleanings per year)
$80 $20* 75%
Fluoride Varnish $35 $25 28%
Fillings - Tooth Colored
Front Tooth - 1 Surface $123 $85 31%
Front Tooth - 2 Surfaces $163 $105 36%
Front Tooth - 3 Surfaces $199 $110 45%
Back Tooth - 1 Surface $143 $100 30%
Back Tooth - 2 Surfaces  $263 $125 52%
Back Tooth - 3 Surfaces $333 $145 56%
Crowns
Ceramic $1,408 $850 40%
Porcelain to Fused High Noble $1,314 $750 43%
Porcelain Fused to Base Metal $1,055 $495 53%
Build- up $331 $135 59%
Implant Crown (EXT/Implant/Cust Abut/PFM) $4,693 $2,995* 36%
Periodontics
Root Planing & Scaling - full quad $318 $130 59%
Root Planing & Scaling-1-3 teeth $174 $75 57%
Perio Maintenance $162 $75 54%
Oral Irrigation- per quad $15 $10 33%
Endodontics
Root Canal - Front $828 $425* 49%
Root Canal - Bicuspid $994 $480* 52%
Root Canal - Molar $1,323 $860* 24%
Dentures
Complete Upper $1,133 $825 27%
Complete Lower $1,133 $675 40%
Upgraded Teeth - Per Arch $0 $500 0%
Oral Surgery
Extraction - Simple $156 $115* 26%
Extraction - Surgical $232 $175* 25%

These fee examples are for services performed by a general dentist in Colorado.  Fees and savings will vary slightly from this schedule in Arizona and New Mexico.

*Fees will vary if treatment is performed by a specialist; click on the blue hyperlink for more detailed fees.