Fees

• $64 D0120 Periodic Exam
• $110 D0150 Comprehensive Exam
• $38 D0220 Intraoral PA xray
• $33 D0230 Each Additional PA
• $83 D0274 (4)Bitewing xrays
• $142 D0330 Panoramic xray
• $115 D1110 Adult Prophy (cleaning)
• $90 D1120 Child Prophy (cleaning)
• $61 D1206 Topical Application of Fluoride
• $75 D1351 Sealant –per tooth
• $298 D2392 2 Surface composite filling
• $176 D4910 Periodontal Maintenance