Fee Schedule
 

       Description

Fee

   

Prophylaxis/Cleaning

$115

Periapical x-ray

$34

Periodic exam

$65

4 Bitewing x-rays

$70

Comprehensive exam

$110

Full Mouth X-rays

$156

Porcelain Crown

$1,425

2 surface posterior composite

$276

Limited Oral Exam

$92

1 surface posterior composite

$222

Crown Build-Up

$320

Surgical Extraction

$340

3 surface posterior composite

$332

Extraction of impacted tooth

$560

Occlusal Guard

$750

 

 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 303-773-0960 to discuss payment options prior to receiving a 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.