Smile Select_summary_01

That is what we like the most — the plan is straightforward, easy to use, and easy to understand!

We know the importance of taking care of our oral health, but a visit to the dentist can be expensive. This plan allows us to get our exams and x-rays at no charge along with regular cleanings at a price we can afford. What we like most about the plan is knowing up front exactly what we will pay. This helps us maintain healthy smiles and a healthy budget for years to come!

Smile Select_summary_02

This plan gives me peace of mind and fits in my budget!

I am a proud parent of four active kids. I know an unexpected dental expense can happen at any time, which is why I need to be prepared. This plan allows me to do that and it fits in my budget. Routine exams are covered at no charge and cleanings are affordable. This plan gives me peace of mind by allowing me to take care of our dental needs at an affordable price.

Smile Select_summary_03

We live a healthy life and know maintaining good oral health is an important part of that!

Not going to the dentist to avoid expensive dental bills is not an option for us. Daily brushing, flossing, and regular dental visits are all top priorities. We live an active life and do not want dental problems to slow us down. At our age, oral health is a key component of overall health. This plan allows us to maintain that. Finally, a plan with REAL discounts!

Summary of Discounts Fees

ADA
Code
Smile Select Fee Schedule Member Pays
Diagnostic + Preventative
D0120 Periodic Oral Evaluation NO CHARGE
D0140 Limited Oral Evaluation – problem focused NO CHARGE
D0150 Comprehensive Oral Evaluation NO CHARGE
D0210 Intraoral – Complete Series (including bitewings) NO CHARGE
D0220 Intraoral – Periapical first film NO CHARGE
D0230 Intraoral – Periapical each additional image NO CHARGE
D0330 Panoramic X-ray NO CHARGE
D1110 Prophylaxis – Adult (cleaning & polishing) $60.00
D1120 Prophylaxis – Child (cleaning & polishing) $40.00
D1206 Topical Application of fluroide varnish $27.00
D1208 Topical Application of fluroide $24.00
D1351 Sealant – per tooth $28.00
Restorative – Fillings
Resin-based composite-anterior
D2330 One Surface $121.00
D2331 Two Surfaces $137.00
D2332 Three Surfaces $167.00
Resin-based composite-posterior
D2391 One Surface $122.00
D2392 Two Surfaces $158.00
D2393 Three Surfaces $199.00
Restorative – Crowns
D2740 Crown – porcelain/ceramic substrate *25% off UCR
D2750 Crown – porcelain fused to high noble metal *25% off UCR
D2950 Crown buildup, including any pins *25% off UCR
D2954 Prefab post & core in addition to crown *25% off UCR
Endodontics
D3220 Therapeutic pulpotomy $148.00
D3310 Root canal – anterior $598.00
D3320 Root canal – bicuspid $698.00
D3330 Root canal – molar *25% off UCR
ADA
Code
Smile Select Fee Schedule Member Pays
Periodontics
D4341 Perio scaling & root planing – four or more teeth per quad $150.00
D4342 Perio scaling & root planing – one to three teeth per quad $120.00
D4355 Full Mouth debridement $130.00
D4381 Localized delivery of antimicrobial agents $83.00
D4910 Periodontal maintenance – single visit $105.00
D4921 Gingival irrigation – per quadrant $64.00
Prosthodontics – Removable
D5110 Complete denture – maxillary (upper) *25% off UCR
D5120 Complete denture – mandibular (lower) *25% off UCR
D5213 Partial denture – maxillary (upper) *25% off UCR
D5214 Partial denture – mandibular (lower) *25% off UCR
Prosthodontics – Fixed
D6058 Abutment supported porcelain/ceramic crown *25% off UCR
D6059 Abutment supported porcelain fused to high noble metal *25% off UCR
D6240 Pontic – porcelain fused to high noble metal *25% off UCR
D6245 Pontic – porcelain/ceramic *25% off UCR
D6740 Crown – porcelain/ceramic *25% off UCR
D6750 Crown – porcelain fused to high noble metal *25% off UCR
Oral Surgery – Extractions
D7140 Extraction erupted tooth *25% off UCR
D7210 Surgical removal of tooth *25% off UCR
D7220 Impacted tooth – soft tissue *25% off UCR
D7230 Impacted tooth – partial bony *25% off UCR
D7953 Bone replacement graft per site *25% off UCR
Orthodontic Services
D8010-D8999 Orthodontic Treatment *25% off UCR
Other Services
D9910 Application of desensitize medicine $45.00
D9940 Occlusal guard *25% off UCR

25% Savings!

on Smile select Dental Plan

On services not listed on Summary

For a complete summary of your discount please click here