Savings Summary
Maximize the value of membership with exclusive member discounts on included dental services.
| ADA Code | Procedure Description | Member Pays* |
|---|---|---|
| DIAGNOSTIC & PREVENTATIVE | ||
| D0120 | Periodic Exam* | No Charge |
| D0140 | Periodic Exam - Problem Focused* | No Charge |
| D0150 | Comprehensive Exam* | No Charge |
| D0210 | Full Mouth X-Rays* | No Charge |
| D0220 | X-Ray - First Image* | No Charge |
| D0230 | X-Ray - Each Add'l Image* | No Charge |
| D0270 | Bitewings - 1 Image* | No Charge |
| D0272 | Bitewings - 2 Images* | No Charge |
| D0274 | Bitewings - 4 Images* | No Charge |
| D0330 | Panoramic X-Rays* | No Charge |
| D0431 | Oral Cancer Screening | No Charge |
| D1110 | Adult Cleaning | 25% off |
| D1120 | Child Cleaning | 25% off |
| D1206 | Fluoride - Including Varnish | 25% off |
| D1208 | Topical Application of Fluoride | 25% off |
| D1351 | Sealant - Per Tooth | 25% Off |
| D4341 | Perio Scaling/Root Planing - 4+ teeth | 20% Off |
| D4342 | Perio scaling / root planing - 1-3 teeth per quad | 20% Off |
| D4910 | Periodontal Maintenance | 20% Off |
| D1208 | Topical Application of Fluoride | 20% Off |
| RESTORATIVE | ||
| D2330 – D2335 | Composite Filling - One Surface – Four Surfaces, Anterior | 20% Off |
| D2391 – D2394 | Composite Filling - One Surface – Four Surfaces, Posterior | 20% Off |
| D2740 | Crown - Porcelain/Ceramic | 20% Off |
| D2920 | Crown - Recementation | 20% Off |
| D2950 | Core Buildup, including any pins | 20% Off |
| Endodontics & Periodontics | ||
| D3310 | Root Canal - Anterior | 20% off |
| D3320 | Root Canal - Bicuspid | 20% Off |
| D3330 | Root Canal - Molar | 20% Off |
| D4341 | Perio Scaling / Root Planing - 4+ teeth per quad | 20% off |
| D4342 | Perio Scaling / Root Planing - 1-3 teeth per quad | 20% off |
| D4910 | Periodontal Maintenance | 20% off |
| Prosthodontics & Oral Surgery | ||
| D5110 & D5120 | Complete Denture - upper or lower | 20% off |
| D5130 & D5140 | Immediate Denture - upper or lower | 20% off |
| D5213 & D5214 | Partial Denture w/Metal Frame - upper or lower | 20% off |
| D5225 & D5226 | Partial Denture w/Flexible Base - upper or lower | 20% off |
| D7111 | Single Extraction | 20% off |
| D7140 | Simple Extraction | 20% Off |
| D7210 | Surgical Extraction | 20% Off |
| D7240 | Impacted tooth – completely bony | 20% Off |
| Orthodontics | ||
| 8670 | Periodic Orthodontic treatment visit | 20% off |
| D8020/D8040 | Limited Orthodontics - Child or Adult | 20% off |
| D8080/D8090 | Comprehensive Orthodontics - Child or Adult | 20% off |
| General Services | ||
| D9230 | Nitrous Oxide | 20% off |
| D9910 | Application of Desensitizing Medicament | 20% off |
*Services listed on Summary of Discounts, with the exception of Orthodontic services, are performed by your selected general dentist. Certain procedures may not be within the scope of practice or the ability of the general dentist. Free Exams, X-Rays, and Cleanings are limited to 2 per annual membership term.
View Fee Schedule(s)