D0150 COMPREHENSIVE EVALUATION FREE D0120 PERIODIC EVALUATION $15.00 D0140 LIMITED EVALUATION FREE D0274 BITEWING FOUR IMAGES FREE D0330 PANORAMIC IMAGES $ 35.00 D0367 CT CAPTURE, BOTH JAWS $ 350.00 D1110 PROPHYLAXIS – ADULT FREE D1120 PROPHYLAXIS – CHILD FREE D2330 ANTERIOR RESIN COMPOSITE 1s $ 90.00 D2391 POSTERIOR RESIN COMPOSITE 1s $ 120.00 D2740 FULL PORCELAIN / CERAMIC CROWN $ 825.00 D2950 CORE BUILDUP W/ ANY PINS $ 190.00 D3310 ROOT CANAL THERAPY ON ANTERIOR $ 900.00 D3320 ROOT CANAL THERAPY ON BICUSPID $ 950.00 D3330 ROOT CANAL THERAPY ON MOLAR $ 1000.00 D4341 SCALING & ROOT PLANNING (4-8) PER QUAT FREE D4355 FULL MOUTH DEBRIDEMENT FREE D4910 PERIODONTAL MAINTENANCE FREE D5110 FULL UPPER DENTURE $ 1100.00 D5225 UPPER PARTIAL W/ FLEXIBLE BASE $ 1300 D6010 Endosteal Implant Placement $ 1500 D6057 Custom Abutment $ 500 D6059 PORCELAIN/HNM CROWN $ 1000 D7140 ROUTINE EXTRACTION $ 175 D7210 SURGICAL EXTRACTION $ 225 D7230 REMOVE PB IMPACTED TOOTH $ 375 D8080 COMPREHENSIVE ORTHO FOR TEEN $ 4500 D8090 COMPREHENSIVE ORTHO FOR ADULT $ 4500 EXTERNAL BLEACHING-OFFICE-ARCH TOOTHBRUSH ORAL B $ 100
