PPO Plan (Standard)

typical cost for an adult

no coverage

PPO Plan

  Two periodic exams

$72

$0

 
  Four bitewing X-rays

$47

$0

 
  Two quadrants of periodontal scaling and root planing

$290

$116*

 
  Three routine cleanings

$140

$0

 
  One resin/ Composite 1-Surface filing (anterior)

$115

$12*

 
  Anterior Root Canal (excluding final restoration)

$576

$230*

 
  Porcelain Crown

$912

$365*

 
 

Subtotal

$2,152

$723

 
 

You Would Save

 

$1,429

 

* based on In-network providers with the deductible having been satisfied

typical cost for a child

no coverage

PPO Plan

  Two periodic Exams

$72

$0

 
  Two Bitewing X-rays

$31

$0

 
  Three routine cleanings

$100

$0

 
  Two Fluoride Treatments

$148

$0

 
  Single Extraction

$109

$44*

 
 

Subtotal

$460

$44

 
 

You Would Save

 

$416

 

* based on In-network providers with the deductible having been satisfied

Plan HighLights

THREE (3) COVERED DENTAL CLEANINGS PER YEAR

INCREASED CALENDAR YEAR MAXIMUM - $1500

No Waiting Periods

Freedom to go to any dentist

Most Diagnostic and Preventive care at No Charge

Prenatal care included

Oral Cancer Screenings included