Savings Summary
ADA CodeProcedure DescriptionMember Pays*
Preventative & Diagnostic
0120Periodic ExamNO CHARGE
0150Comprehensive ExamNO CHARGE
0210Full Mouth X-RaysNO CHARGE
0273Bitewings - Four ImagesNO CHARGE
0330Panoramic X-RaysNO CHARGE
1110Adult Cleaning30% Off
1120Child Cleaning30% Off
1351Sealant - Per Tooth30% Off
Restorative
2330Filling - 1 Surface, Anterior30% Off
2392Filling - 1 Surfaces, Posterior30% Off
2740Crown - Porcelain/Ceramic30% Off
2750Crown - Porcelain/High Noble Metal30% Off
2950Core Buildup30% Off
Endodontics & Periodontics
3320Root Canal - Bicuspid30% Off
3330Root Canal - Molar30% Off
4341Perio scaling & root planing - (4+ teeth per quad)30% Off
Prosthodontics & Oral Surgery
7140Simple Extraction30% Off
7210Surgical Extraction 30% Off

*Member savings may vary by location. Free exams limited to 2x per member/per annual membership term. Free x-rays limited to 1x per member/per annual membership term.