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Smilebuilderz Dental Plan Fee Schedule

Keeping Dental Care Affordable and Accessible

Scroll table side to side to view all data.

Service Regular Fee Discount ADV/Select/Senior
New Patient Exam $138 100% $0
Existing Patient Exam $90 100% $0
Emergency Exam $108 100% $0
Complete Set of XRAYS $189 100% $0
Single XRAY $45 100% $0
Panoramic Film $165 100% $0
Cleaning (12 and up) $138 25% $104
Child Cleaning* $99 25% $74
Fluoride $57 47% $30
Sealants $66 25% $50
White Filling (1 surface) $251 25% $188
Whilte Filling (2 surface) $292 25% $219
White Filling (3 surface) $362 25% $272
White Filling (4 surface) $441 25% $331
White Crown (Porcelain/Zirconia) $1,447 25% $1,085
Veneer $1,467 25% $1,100
Root Canal Front Tooth $999 25% $749
Root Canal Premolar $1,279 25% $959
Root Canal Molar $1,359 25% $1,019
Deep Cleaning (Quadrant) $363 40% $218
Gum Surgery $1,789 40% $1,074
Perio Maintenance $221 40% $133
Denture (upper) $2,156 20% $1,725
Denture (lower) $2,122 20% $1,698
Partial Denture (Upper) $2,262 20% $1,810
Partial Denture (Lower) $2,233 20% $1,787
Dental implant $2,080 25% $1,560
Custom Abutment $600 25% $450
Implant Crown $1,891 25% $1,418
Extraction $394 20% $315
Wisdom Tooth Extraction $788 20% $630
Braces $6,676 25% $5,500
Invisalign $8,000 25% $6,000
Nitrous $167 20% $134
Sedation $609 / 15 min 25% $487
Take Home Bleaching $436 20% $349
In Office Whitening $715 20% $572

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