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Members Fee Schedule
Please scroll down to look at all of the dental benefits you receive!

  

Non-member Average Fee Member's Fees
DIAGNOSTIC AND PREVENTATIVE
Office Visit $75.00 3
Emergency Office Visit 90 10
Infection Control
30% OFF

X-Ray, Intraoral Pericapical, each

10 1
X-Ray, Bitewings, each 10 1
X-Ray, Panoramic Film 125 20
X-Ray, Complete Series, Full Mouth 150 25
Routine Cleaning (incl. polishing & routine scaling) 95 21

Sealant, per tooth

65 17
Comprehensive   Oral Evaluation

95
20
FILLINGS, CROWNS, AND BRIDGES
Silver Filling (Amalgam) primary or permanent

1 Surface 105 28

2 Surfaces 155 34

3 Surfaces 185 48

4 Surfaces 225 65
Tooth-Colored Fillings (Resin-based Composite) Anterior, Posterior, or involving Incisal Angle

1 Surface 150 46

2 Surfaces 210 56

3 Surfaces 260 90

4 Surfaces 310 100
Porcelain Crown fused to:
Non-precious or predominately base metal. 950 353
Noble or High Noble metal
1200 415
Full crown cast noble or High Noble metal 1200 383
Full crown cast nonprecious metal. 1200 310
Core Buildup, including any pins 230 90
Prefab Crown, Provisional or permanent 225 90
Fixed Bridge (Crown/Pontic Priced Per Unit)




ENDODONTICS (Root Canals, etc)
Pulp Cap - Direct 75 18
Pulp Cap - Indirect 75 18
Root Canal (excluding final restoration)


Anterior 600 185

Bicuspid 750 235

Molar 900 305
 

TOOTH REMOVAL/EXTRACTIONS (Performed by General Dentist)
Single Tooth, simple extraction, erupted tooth or exposed root 125 35
Impacted Tooth – Soft tissue 225 78
Impacted Tooth – Partially bony 275 85
Impacted Tooth – Completely bony 350 95
Surgical Removal resid. Roots 225 80
PROSTHODONTICS (Dentures, Partials, etc.)
Upper Full Denture   1400 390
Lower Full Denture     1400 390
Immediate Denture 1200 370
Upper partial 1400 390
Lower partial 1400 390
Flexible Partial or Complete
30% OFF
Repair broken complete denture base 115 45
Replace missing/broken teeth – complete denture (each tooth) 110 40
Lab Cost will be extra

 

PERIODONTICS (Performed by a General Dentist)
Consultation 75 10
Periodontal Scaling and Root Planing 4+ teeth Per Quadrant 195 65
Gingival Curettage 4+ Per Quadrant 225 65
Gingivectomy or Gingioplasy Per Quad 450 200
 

ORTHODONTICS

Conventional Braces
25% OFF
Cosmetic Braces
25% OFF
Any Orthodontic Treatment
25% OFF
 
Any treatment performed by a participating advanced degree specialist in Endodontics, Pedodontics, Periodontics, Orthodontics, Prosthodontics and Oral Surgery will be charged at a 25% reduction off participating specialist standard fees.




All General Dentistry not listed on fee schedule will be charged at a 30% Discount. Discuss all fees with dentist prior to any treatment.




For all treatments, Lab Cost may be charged in addition to scheduled fees.

Prices are subject to change without notice.

 

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American Dental Care Partners, Inc.
11221 Katy Freeway Suite 209 Houston, Texas 77079
Phone 713-784-9696  *  Facsimile 713-784-6928
Toll Free 800-452-4468
Email: adc@americandentalcareinc.com