Savings to Smile About
Maximize the value of membership with exclusive member discounts on most dental services.
| ADA Code | Procedure Description | Member Pays* |
|---|---|---|
| D0150 | Comprehensive Oral Evaluation | Select State |
| D0210 | Complete Series - Including Bitewings | Select State |
| D0330 | Panoramic Film | Select State |
| D0120 | Periodic Oral Evaluation | Select State |
| D0140 | Limited Oral Evaluation - Problem Focused | Select State |
| D0220 | Periapical - First Film | Select State |
| D0230 | Periapical - Each Additional Film | Select State |
| D0270 | Bitewing - Single Film | Select State |
| D0272 | Bitewings - Two Films | Select State |
| D0274 | Bitewings - Four Films | Select State |
| Restorative & Preventative | ||
| D2330 | D1110 | Select State |
| D2331 | Fluoride – Including Varnish | Select State |
| D1351 | Sealant - Per Tooth | Select State |
| D2330 | Composite Filling - One Surface, Anterior | Select State |
| D2391 | Composite Filling - One Surface, Posterior | Select State |
| D2740 | Crown - Porcelain/Ceramic | Select State |
| D2950 | Core Buildup - Including Pins | Select State |
| Endodontics & Periodontics | ||
| D3230 | Pulpal Therapy – Anterior, Primary Tooth | Select State |
| D3310 | Root Canal - Anterior | Select State |
| Prosthodontics & Oral Surgery | ||
| D7140 | Simple Extraction | Select State |
| D7210 | Surgical Extraction | Select State |
*Services listed on the Savings Summary, with the exception of orthodontic services, are performed by your selected general dentist. Certain procedures may not be within the scope of practice or the ability of the general dentist. In such cases, if a participating specialist is available to perform such procedures they will be provided at a 20–40% discount off Retail Fee(s).