Most Common Procedure Fee's


The following is a list of some of our usual and customary fees:

1.) D0150: Comprehensive Oral Evaluation/Established Patient - $75
2.) D0120: Periodic Oral Evaluation - $50
3.) D0140: Limited Oral Evaluation Problem Focused - $50
4.) D0220: Intraoral Periapical First Radiographic Image - $25
5.) D0274: Bitewings - Four Radiographic Images - $58
6.) D0330: Panoramic Radiographic Image - $125
7.) D1110: Prophylaxis Adult - $93
8.) D1120: Prophylaxis Child - $67
9.) D2391: Resin Composite One Surface Posterior - $180
10.) D2392: Resin Composite Two Surface Posterior - $201
11.) D2393: Resin Composite Three Surface Posterior - $239
12.) D2394: Resin Composite Four/More Surface Anterior - $274
13.) D2950: Core Buildup Including Pins - $310
14.) D2750: Crown Porcelain Fused High Noble Metal - $1125
15.) D7210: Surgical Removal Erupted Tooth - $244

Important Note:

"The health care price listed for any given health care service is an estimate. Actual charges for the health care service are dependent on the circumstances, including any complications or exceptional treatment, at the time the service is rendered.  

"If you are covered by health insurance or a dental plan, you are strongly encouraged to consult with your insurer or plan to determine accurate information about your financial responsibility for a particular health care service provided by a health care provider at this office. If you are not covered by health insurance or a dental plan, you are strongly encouraged to contact our billing office at 303-671-0761 to discuss payment options prior to receiving any health care service from a health care provider at this office since posted health care prices may not reflect the actual amount of your financial responsibility."