Summary of Discounts

With easy enrollment and instant savings, Essential Dental Plan gives you access to 15% off dental services and no charge on preventative services such as exams, X-rays and oral cancer screenings. Simply present your card at your appointment and your discount will be applied. It’s that easy!

Summary of Discounted Fees

ADA Code Description Member
Pays
Diagnostic and Preventative
D0120Periodic Oral EvaluationNo Charge
D0140Limited Oral Evaluation - Problem FocusedNo Charge
D0150Comprehensive Oral EvaluationNo Charge
D0210X-Rays - Complete SetNo Charge
D0220Intraoral - First FilmNo Charge
D0230Intraoral - Each Additional FilmNo Charge
D0272Bitewings - Two FilmsNo Charge
D0274Bitewings - Four FilmsNo Charge
D0330Panoramic X-RayNo Charge
D0431Adjunctive Oral Cancer ExamNo Charge
D1110Cleaning - Adult$85.00
D1120Cleaning - Child$75.00
D1206Topical Application of Fluoride Varnish$35.00
D1351Sealant - Per Tooth$50.00
Restorative - Fillings
Resin-based composite-anterior
D2330One Surface15% off UCR
D2331Two Surfaces15% off UCR
D2331Three Surfaces15% off UCR
Resin-based composite-posterior
D2391One Surface15% off UCR
D2392Two Surfaces15% off UCR
D2393Three Surfaces15% off UCR
Restorative - Crowns
D2740Crown - porcelain/ceramic substrate15% off UCR
D2750Crown - porcelain fused to high noble metal15% off UCR
D2950Crown buildup, including any pins15% off UCR
D2954Prefab post & core in addition to crown15% off UCR
Endodontics
D3310Root canal - anterior15% off UCR
D3320Root canal - bicuspid15% off UCR
D3330Root canal - molar15% off UCR
Periodontics
D4341Perio scaling & root planing - four or more teeth per quad15% off UCR
D4342Perio scaling & root planing - one to three teeth per quad15% off UCR
D4355Full mouth debridement15% off UCR
D4381Localized delivery of antimicrobial agents15% off UCR
D4910Periodontal maintenance - single visit$125.00
Prosthodontics - Removable
D5110Complete denture - maxillary (upper)15% off UCR
D5120Complete denture - mandibular (lower)15% off UCR
D5213Partial denture - maxillary (upper)15% off UCR
D5214Partial denture - mandibular (lower)15% off UCR
Prosthodontics - Fixed
D6058Abutment supported porcelain/ceramic crown15% off UCR
D6059Abutment supported porcelain fused to high noble15% off UCR
D6240Pontic - porcelain fused to high noble metal15% off UCR
D6245Pontic - porcelain/ceramic15% off UCR
D6740Crown - porcelain/ceramic15% off UCR
D6750Crown - porcelain fused to high noble metal15% off UCR
Oral Surgery - Extractions
D7140Extraction, erupted tooth15% off UCR
D7210Surgical removal of tooth15% off UCR
D7220Impacted tooth - soft tissue15% off UCR
D7230Impacted tooth - partial bony15% off UCR
D7953Bone replacment graft per site15% off UCR
Orthodontic Services
D8010-D8999Orthodontic Treatment 15% off UCR
Other Services
D9975Take-Home Whitening Trays$99.00

15% Savings off all other services

Participating Dental Providers have agreed to discount their usual and customary fees ("UCR") by 15%, provided those ADA codes or services are offered in office. "Usual" refers to the normal rate charged for the service by the Provider rendering the treatment, and "Customary" is defined as the usual rates of the Providers in the local area. The UCR can vary by location, provided those ADA codes are offered in office.

Click here to view the General Dentist Fee Schedule.