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

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.

Prosthodontic Rates & Procedures
Services are provided by a Prosthodontist, a Specialist with additional
training in this field.
Regional Fee Network Fee Typical Network Savings Typical % Savings
Initial clinical exam $225 $150 $75 33%
Follow-up exam (established patient) $75 $45 $30 40%
Extended consultation (may include charting) $225 $150 $75 33%
Consultation or second opinion (may include charting) $195 $135 $60 31%
Emergency office visit $150 $110 $40 27%
Prophylaxis (when performed by hygienist) $95 -115 $70 $40 36%
Prophylaxis (when performed by dentist) $140 $90 $50 36%
Antimicrobial Therapy, Initial Dose $160 $115 $45 28%
Antimicrobial Therapy, Additional Dose $60 $45 $15 25%
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 33%
X-Ray Panorex $125 $85 $40 32%
X-Ray Full Mouth, Including Bitewings (complete) $115 – $165 $85 $60 39%
Extraction (simple) $300 $200 $100 33%
Night Guard (acrylic – laboratory processed) $600 – $700 $450 $200 31%
Processed acrylic temps. $350 $250 $100 29%
Intra-Coronal Resin/Fiberglass Splint (per tooth) $250 $200 $50 20%
Models (if necessary), includes upper & lower $120 $85 $35 29%
White
Bonded Composite Fillings:
– Composite resin is an important component
of restorative and cosmetic dentistry. Color matching is of particular
importance in anterior (front) fillings and in a variety of bonding applications.
Fees shown below for fillings apply to new fillings or replacement of
old fillings.
White Composite Resin Fillings – Anterior        
White composite resin filling – 1 surface – anterior $175 – $225 $140 $60 30%
White composite resin filling – 2 surface – anterior $235 – $285 $175 $85 33%
White composite resin filling – 3 surface – anterior $385 $285 $100 25%
White composite resin filling – 4 surface – anterior $450 $335 $115 25%
White Composite Resin Fillings – Posterior        
White composite resin filling – 1 surface – posterior $185 – $235 $150 $60 29%
White composite resin filling – 2 surface – posterior $245 – $295 $185 $85 31%
White composite resin filling – 3 surface – posterior $385 $285 $100 25%
White composite resin filling – 4 surface – posterior $450 $335 $115 25%
Bonding Note: In some cases bonding is
used for relatively small repairs and in other cases a larger portion
of tooth surface is involved. Fees will vary accordingly and Network savings
will be in the range of 33% for all bonding procedures.
       
Bonding, per tooth $350 – $700 $200 –
$550
$175 33%
Note: Fees vary for some procedures, as shown,
based upon materials, lab fees, and other professional considerations.
Dentist will confirm UCR fee and variables, if any, upon request.

Cosmetic Procedures:        
Diagnostic Waxup (treatment planning and aesthetic workup) $2000 $1750 $250 12%
Porcelain Laminate Veneer $1400 – $1700 $1100
– $1325
$338 22%
Porcelain Inlay (including composite temp.) $1550 $1150 $400 26%
*Tooth Whitening/Bleaching exam notes: Your
dentist must determine that teeth and gums are in suitable conditon, and
which process may be most appropriate, prior to cosmetic tooth whitening.
If prophylaxis has not been performed recently, your dentist may require
same. The additional fee for prophylaxis, if necessary, will be the adult
or child prophylaxis fee shown on this schedule. Note also that some dental
offices offer a (range) of cosmetic tooth whitening options, based upon
different shades of whitening. There appears to be a fairly wide range of
cost associated with treatment options. To avoid confusion, this schedule
concerns itself with complete, full-range whitening.
Cosmetic Tooth Whitening: Includes Oral Exam, Two office visits, Full
mouth impressions and models, Whitening trays, All materials, At home application
of whitening material (See exam* and prophylaxis notes below.) 
$350 – $500 $275 $150 35%
Cosmetic Tooth Whitening: Accelerated tooth whitening procedure using
high intensity light, includes one or more office visits, Oral Exam, All
materials. This is complete, full range whitening, not a limited application.

(See exam* and prophylaxis notes below.)
$500 – $650 $330 $245 43%

Cosmetic Tooth Whitening: Accelerated tooth whitening
procedure using high intensity light, includes one or more office visits,
Oral Exam, All materials. This is complete, full range whitening, not
a limited application.

(See exam* and prophylaxis notes below.)

Alternate Fee – Certain Manhattan Locations Only
– Please consult your dentist

$550 – $680 $345 $270 44%
Cosmetic Tooth Whitening: Accelerated tooth whitening procedure using
high intensity light, includes one or more office visits, Oral Exam, Full
mouth impressions and models, Whitening Trays, All materials for at-home
follow up. Combines office and take-home procedures shown above. (See exam*
and prophylaxis notes below.)
$650 – $800 $500 –
$550
$200 28%
Crowns and Onlays: A typical
crown procedure includes two office visits to prepare the tooth, take
impressions, install temporary crown, and install permanent crown. Lab
fees are included in rates shown. In some cases, fees may vary due to
cost of gold or other materials selected. To determine member savings,
please ask your dentist to confirm his/her UCR fee. Please see separate
fees for post and core, sometimes needed in addition to crown.
       
Crown (Porcelain fused to High Noble Metal) $1400 – $1850 $1100 $520 32%
Crown (Porcelain fused to High Noble Metal)
Alternate
Fee – Certain Manhattan Locations Only – Please consult with your dentist.
$1400 – $1900 $1125 $525 32%
Crown, per tooth if fixed bridge $1400 – $1850 $1150 $525 32%
All Porcelain Crown $1600 – $2100 $1275 $575 31%
All Porcelain Crown
Alternate Fee – Certain
Manhattan Locations Only – Please consult with your dentist.
$1600 – $2250 $1350 $575 30%
Cad-Cam Crown $1600 – $2100 $1300 $600 32%
Gold Onlay $1400 – $1800 $1050 $550 34%
Porcelain Onlay $1750 $1250 $500 21%
Provisional (temporary) Crown
interim short-term restoration
$350 $225 $125 36%
Post and Core (Prefab.) $450 $300 $150 33%
Post and Core (Cast) $600 – $750 $475 $200 30%
Recement Crown $90 – $110 $55 $45 45%
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%
Dentures:        
Lab hard reline (per arch) $1000 – $1250 $800 –
$950
$250 22%
Complete Denture (per arch) $2800 – $3600 $2000
– $2600
$800 26%
Transitional Partial Denture (lab processed) $1700 $1300
– $1500
$300 18%
Interim Partial Denture (flipper) $850 $650 $200 24%
Semi-Precision Partial Denture $3000 – $4000 $2000
– $3000
$1000 29%
Clasp Partial Denture $2500 – $3500 $2000
– $2500
$750 25%
Note: Implant Supported Bar Overdenture – please
consult with dentist due to variation in treatment and professional fees
associated with this procedure
       
Implant Supported Bar Overdenture (consult with dentist) $10,000 $8,000 $2000 20%

*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 College of Prosthodontists
gotoapro.org