Savings to Smile About
Below is a list of common dental services and what you’ll pay with Convenient Dental Plan.
Savings Summary
| ADA Code | Procedure Description | Member Pays* |
|---|---|---|
| Preventive & Diagnostic | ||
| D0120 | Periodic Exam | NO CHARGE |
| D0140 | Limited Exam - Problem Focused | NO CHARGE |
| D0150 | Comprehensive Exam | NO CHARGE |
| D0210 | Full Mouth X-Rays | NO CHARGE |
| D0330 | Panoramic X-Rays | 20% OFF |
| D1110 | Adult Cleaning | 20% OFF |
| D1120 | Child Cleaning | 20% OFF |
| D1206 | Fluoride - Including Varnish | 20% OFF |
| D1351 | Sealant - Per Tooth | 20% OFF |
| Restorative | ||
| D2330 | Filling - 1 Surface, Anterior | 20% OFF |
| D2391 | Filling - 1 Surface, Posterior | 20% OFF |
| D2740 | Crown - Porcelain/Ceramic | 20% OFF |
| D2750 | Crown - Porcelain/High Noble Metal | 20% OFF |
| D2950 | Core Buildup - Including Pins | 2O% 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 | 20% OFF |
| D4910 | Periodontal Maintenance | 20% OFF |
| Prosthodontics & Oral Surgery | ||
| D5110 | Complete Denture (Upper or Lower) | 20% OFF |
| D5213 | Partial Denture (Upper or Lower) | 20% OFF |
| D7140 | Simple Extraction | 20% OFF |
| D7210 | Surgical Extraction | 20% OFF |
| Orthodontics | ||
| D8080 | Comprehensive Orthodontics - Child | 20% OFF |
| D8090 | Comprehensive Orthodontics - Adult | 20% OFF |
*Member savings may vary by location. Free exams and x-rays limited to 2x per member/per annual membership term.
View Fee Schedule(s)