1. D0120 — $80.00

Periodic oral evaluation

2. D2740 — $1,039.05

All-ceramic crown

3. D2392 — $183.14

Resin composite, 2-surface posterior

4. D2393 — $222.82

Resin composite, 3-surface posterior

5. D0140 — $119.00

Limited/problem-focused exam

6. D0150 — $143.00

Comprehensive oral exam

7. D2332 — $188.99

Resin composite, 2-surface anterior

8. D0210 — $204.00

Full-mouth X-rays (FMX)

9. D2394 — $251.73

Resin composite, 4+ surfaces posterior

10. D2950 — $226.02

Core buildup

11. D2335 — $244.64

Resin composite, 4+ surfaces / incisal angle

12. D2391 — $145.82

Resin composite, 1-surface posterior

13. D0364 — $96.86

Limited field CBCT

14. D2920 — $96.94

Re-cement crown

15. D2954 — $289.08

Prefabricated post & core

16. D2331 — $148.74

Resin composite, 1-surface anterior

17. D3310 — $697.77

Root canal — anterior

18. D0367 — $219.77

CBCT, both jaws

19. D3110 — $41.33

Pulp cap (direct)

20. D3120 — $38.50

Pulp cap (indirect)

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