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Dental Fee Survey for New York City Metro area
Network Fee Schedule – Periodontics

The schedule below is a comprehensive survey of regional
Usual and Customary Fees (UCR) compared with Reduced Fees paid by Network
Members.

To facilitate access to regular dental care and maintenance for all
household members, you will note exceptional savings on Preventive and
Diagnostic services, including Cleaning, Oral Exams, X-rays, Fluoride
Application, and Sealants, wherever these services appear on a fee schedule.

Member savings range from approximately 20% to 60% across the entire
plan. If there is a question about any fees posted, ask your dentist
about his or her Usual Fee (UCR) so that you can compare same with the
posted Network Fee.

Fees posted may change, without notice, from time to time to reflect
changes in Professional Fees in the NYC Metro area. It is important
that both the member and the dentist refer to the Professional Fee schedules
posted on this website on a regular basis to be sure fees discussed
are current.

Note: For some procedures listed
on this schedule we have posted an alternate, higher fee that may apply
at certain Manhattan practice locations only. Please consult with your
dentist about this.
This Fee Schedule calculates Member Savings in terms of Actual
Savings and Savings Percentage.

Plan members pay fee shown in NETWORK
FEE
column.

Periodontic Rates & Procedures
Services are provided by a Periodontist, a Specialist with additional
training in this field.
Regional Fee Network Fee Typical Network Savings Typical % Savings
Periodontal Exam – Comprehensive $100 – $125 $65 $47 42%
Periodontal Exam – Periodic Exam $65 $40 $25 38%
Periodontal Recall (Exam & Maintenance following Scaling and Root
Planing)
$130 – $180 $100 $55 35%
Periodontal Recall (Exam & Maintenance following
Scaling and Root Planing)
Alternate Fee –
Certain Manhattan Locations Only – Please consult with your dentist.
$140 – $190 $110 $55 34%
Periodontal Charting $65 $40 $25 38%
Diagnostic Impressions (models both arches) $135 – $265 $100 $100 50%
Diagnostic Waxup (includes lab fees) $225 – $325 $175 $100 31%
First Periapical X-ray $25 $15 $10 40%
Each Additional Periapical X-ray $20 $10 $10 50%
X-Ray Bite Wings (complete) $80 $45 $35 31%
X-Ray Panorex Varies 25% below UCR 25%
X-Ray Full Mouth, Including Bitewings (complete) Varies 25% below UCR 25%
Note on Prophylaxis: If Periodontal Gum
Disease is present, quarterly visits for Prophylaxis may be recommended
by your dentist. You will note significant NYDN savings on Prophylaxis
procedures.
       
Prophylaxis (when performed by the Periodontist) $140 $90 $50 36%
Prophylaxis (when performed by the Hygienist) $110 $65 $45 41%
Root planing, per quadrant*
*More complicated cases. (includes local anesthesia)
$425 $325 $100 24%
Chemotherapeutic agents, per tooth $65 – $90 $45 $35 44%
Chemotherapeutic agents, per quadrant $160 – $180 $110 $60 35%
Full Mouth Scaling – Per Quad $275 – $325 $175 $125 42%
Full Mouth Scaling – Per Quad
Alternate
Fee – Certain Manhattan Locations Only – Please consult with your dentist.
$275 – $375 $215 $110 34%
Desensitizing (per quad) $60 – $75 $50 $18 26%
Intra-Oral Incision and Drainage of Abcess $250 – $400 $175 $150 46%
Osseous surgery, per quadrant $1100 – $1450 $880 $395 31%
Osseous surgery, per quadrant
Alternate
Fee – Certain Manhattan Locations Only – Please consult with your dentist.
$1250 – $1550 $950 $450 24%
Mucogingival surgery, per quadrant $1050 – $1200 $825 $250 27%
Note: Crown Lengthening may involve more than
one tooth. If a contiguous tooth is included, the cost per addl. tooth
may be relatively modest. Please consult with your dentist about details.
       
Crown Lengthening (per tooth – see above note) $900 – $1100 $775 $225 22%
Connective Tissue Grafts, per tooth $800 – $1050 $600 $225 36%
Connective Tissue Grafts, per tooth
Alternate
Fee – Certain Manhattan Locations Only – Please consult with your dentist.
$850 – $1150 $675 $325 32%
Free Gingival Grafts, per tooth $800 – $1050 $600 $225 35%
Free Gingival Grafts, per tooth
Alternate
Fee – Certain Manhattan Locations Only – Please consult with your dentist.
$850 – $1150 $675 $325 32%
Bone graft, first tooth, per quad. $600 $475 $125 29%
Bone graft, each additional tooth, per quad. $325 $225 $100 31%
Socket Graft (single tooth) $275 – $350 $225 $87 20%
Guided tissue regeneration, per tooth $225 $160 $65 29%
Biologic Materials to promote tissue regeneration (per site) $450 $350 $100 22%
Ridge Preservation (with straight bone graft) $500 $325 $175 35%
Ridge Preservation (with bone graft and guided tissue regeneration) $750 $550 $200 26%
Soft Tissue Allograft (per site) $850 – $950 $750 $125 17%
Simple Tooth Extraction $250 $170 $80 32%
Surgical Tooth Extraction $400 $280 $120 30%
Implants: The first step of the
Implant procedure is placement into the jaw of a titanium screw that will
anchor the implant abutment and crown. In some cases, it may be necessary
to do bone grafting to build up bone density at implant site.

Implants
– More information

The Crown will be attached to the Implant via an abutment. Often the Crown
and a custom abutment will be created together in a dental lab, to assure
the best fit and long term durability. .

Dental Implant
(complete)
Includes Implant, Crown, and Custom Abutment
Note: Please see variables, including Bone Graft
info.
$3150 – $4150 $2625 $1025 28%
Dental Implant
(complete)
Includes Implant, Crown, and Custom Abutment
Note: Please see variables, including Bone Graft info.
Alternate
Fee – Certain Manhattan Locations Only – Please consult with your dentist.
$3250 – $4400 $2850 $975 25%
Dental Implant
(Surgical Fee) Does not include Crown or Abutment
$1600 – $2400 $1400
$600 30%
Crown + Abutment. Porcelain fused to noble metal + Custom Abutment
$1550 – $1750 $ 1225 $425 26%
Implant
Abutment
Noble Metal, Custom Cast. This entry shows cost of abutment
only.
$450 – $750 $350-$650 $100 17%
Implant
Abutment
Custom Cad Titanium. This entry shows cost of custom abutment
only. Note: In some cases the crown + custom abutment are fabricated together
in same lab, combined cost is shown above.
$550 – $1050 $300
– $950
$175 22%
Implant Bone Graft: An implant
bone graft procedure will be necessary if the (jaw) bone at the implant
site is not sufficiently dense to support the implant. For more information
on this procedure and wide cost variation:

Implant
bone grafts – More information

Implant Bone Graft
Note: Per the above article on Implant Bone Grafts, rates shown here are
for illustration only, as actual cost may be higher or lower, depending
upon amount of bone density reinforcement needed.
$250 – $900 $175
– $650
$163 28%
Anesthesia and Analgesia – In some
cases, the cost of Inhalation Analgesia (nitrous oxide) may be included
in cost of the procedure. In other cases, a separate fee, as shown on
this schedule, may apply. In general, fees for Analgesia and for IV Sedation
are based upon time required for each procedure. In some dental procedures,
conventional medical insurance may cover a portion of the surgical or
anesthesia fees. Consult with your dentist about his/her fees for Analgesia
and Anesthesia to determine network savings.
       
Inhalation Analgesia (Nitrous Oxide) $65 – $95 $45 $35 44%
IV Conscious Sedation (first 30 minutes) $350 – $500 $250 $175 41%
IV Conscious Sedation (additional 15 minutes) $180 – $220 $100 $100 50%

*Regional fees posted are representative of usual and customary fees charged by New York Dental Network, LLC participating dentists for patients who do not participate in a dental benefits plan. Some fee variation was found due to differences in office overhead, materials, lab fees, and other professional considerations.

*Network fees shown are the actual fees members will pay to the participating dentist. For procedures not shown, or variations of listed procedures, similar network fee reductions will apply in most cases. An exception may apply in the case of certain brand name dental products or services. Additionally, fee variations may be based upon degree of difficulty and time and materials involved in treatment. Please consult with your dentist prior to course of treatment.

*When a network fee range is shown, the usual and customary fee (UCR) of the dentist will determine the network fee to be paid by NYDN member. For example, if the dentist’s UCR fee falls in the middle of regional fee range, the dentist will charge NYDN member a fee in the middle of network fee range. If the dentist’s usual fee for a given procedure is lower than the stated network fee, the dentist agrees to charge usual fee, resulting in additional savings for network members.

For more information on Dentisty, the links below may be useful:

American Dental Association
ada.org

American Academy of Periodontology
perio.org