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Lime Dental Fee Schedule
| Sample General Dentist Procedures |
Dental Office Fees up to*
|
Plan Fees
|
Plan Savings
up to*
|
| Periodic Oral Exam |
$40
|
$8
|
80%
|
| Limited Oral Exam |
$65
|
$16
|
75%
|
| Initial Oral Exam |
$76
|
$38
|
50%
|
| X-Ray: Intraoral Complete Series |
$101
|
$70
|
31%
|
| X-Ray: Panoramic |
$94
|
$70
|
26%
|
| Regular Teeth Cleaning (Light Scaling & Polishing) |
$73
|
$40
|
45%
|
| Regular Teeth Cleaning (with Fluoride) |
$95
|
$50
|
47%
|
| Amalgam Filling (Silver Colored) 1 Surface (Anterior) |
|
20% Off Dentist Usual & Customary Fees
|
20%
|
| Composite Filling (Tooth Colored) 1 Surface(Anterior) |
|
20% Off Dentist Usual & Customary Fees
|
20%
|
| Porcelain Crown with High Noble Metal |
|
20% Off Dentist Usual & Customary Fees
|
20%
|
| Root Canal Excluding final restoration |
|
20% Off Dentist Usual & Customary Fees
|
20%
|
| Orthodontic Braces** by General Dentist - children under age 19 |
|
20% Off Dentist Usual & Customary Fees
|
20%
|
*Source: National Dental Advisory Service 2003
Dental Economics, Annual Dental Fee Survey
**Invisalign braces may not be included.
For a complete list of General Dentistry procedures and prices, please click here.
TREATMENT BY SPECIALISTS (Orthodontists, Periodontists, Endodontists, Prosthodontists, Pedodontists, Oral Surgeons) - Members will receive a 15% discount off the participating specialist's usual and customary fees.
The above fee schedule is available in all states except Hawaii, Rhode Island and Puerto Rico. In metropolitan areas, fees may vary. For the appropriate fees in your area, please find a dentist in your area and verify their fee schedule. For fee schedules in other states, please click here.
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