Procedure | ADA Code | Usual Fee1 | With Plan2 | You Save | % Saved |
---|---|---|---|---|---|
Routine 6 month check-up | ADA Code: D0120 | Usual Fee1: $56.00 | With Plan2: $18 | You Save: $38 | Saving Percentage: 68% |
In depth check-up | ADA Code: D0150 | Usual Fee1: $98.00 | With Plan2: $32 | You Save: $66 | Saving Percentage: 67% |
Full mouth x-rays | ADA Code: D0210 | Usual Fee1: $148.00 | With Plan2: $48 | You Save: $100 | Saving Percentage: 68% |
Four bitewing x-rays | ADA Code: D0274 | Usual Fee1: $70.00 | With Plan2: $22 | You Save: $48 | Saving Percentage: 69% |
Panoramic film | ADA Code: D0330 | Usual Fee1: $125.00 | With Plan2: $40 | You Save: $85 | Saving Percentage: 68% |
Adult teeth cleaning | ADA Code: D1110 | Usual Fee1: $99.00 | With Plan2: $33 | You Save: $66 | Saving Percentage: 67% |
Child teeth cleaning | ADA Code: D1120 | Usual Fee1: $76.00 | With Plan2: $24 | You Save: $52 | Saving Percentage: 68% |
Protective sealant / tooth | ADA Code: D1351 | Usual Fee1: $60.00 | With Plan2: $20 | You Save: $40 | Saving Percentage: 67% |
1 surface silver filling for primary or permanent tooth | ADA Code: D2140 | Usual Fee1: $180.00 | With Plan2: $65 | You Save: $115 | Saving Percentage: 64% |
1 surface white filling for u or l front tooth | ADA Code: D2330 | Usual Fee1: $195.00 | With Plan2: $75 | You Save: $120 | Saving Percentage: 62% |
Single crown - porcelain on high noble metal | ADA Code: D2750 | Usual Fee1: $1265.00 | With Plan2: $524 | You Save: $741 | Saving Percentage: 59% |
Single crown - porcelain on noble metal | ADA Code: D2752 | Usual Fee1: $1435.00 | With Plan2: $497 | You Save: $938 | Saving Percentage: 65% |
Core build-up with pins | ADA Code: D2950 | Usual Fee1: $300.00 | With Plan2: $126 | You Save: $174 | Saving Percentage: 58% |
Labial veneer (resin laminate) - direct | ADA Code: D2960 | Usual Fee1: $730.00 | With Plan2: 20% Off | You Save: $146.00* | Saving Percentage: 20% |
Labial veneer (porcelain laminate) - indirect | ADA Code: D2962 | Usual Fee1: $1489.00 | With Plan2: 20% Off | You Save: $297.80* | Saving Percentage: 20% |
Root canal treatment - front tooth | ADA Code: D3310 | Usual Fee1: $1015.00 | With Plan2: $327 | You Save: $688 | Saving Percentage: 68% |
Root canal treatment - bicuspid | ADA Code: D3320 | Usual Fee1: $1151.00 | With Plan2: $391 | You Save: $760 | Saving Percentage: 66% |
Root canal treatment - molar | ADA Code: D3330 | Usual Fee1: $1395.00 | With Plan2: $481 | You Save: $914 | Saving Percentage: 66% |
Bone replacement graft - retained natural tooth - first site in quadrant | ADA Code: D4263 | Usual Fee1: $600.00 | With Plan2: 20% Off | You Save: $120.00* | Saving Percentage: 20% |
Perio scaling and root planing (per quadrant) | ADA Code: D4341 | Usual Fee1: $289.00 | With Plan2: $124 | You Save: $165 | Saving Percentage: 57% |
Regular cleaning following periodontic procedure | ADA Code: D4910 | Usual Fee1: $150.00 | With Plan2: $72 | You Save: $78 | Saving Percentage: 52% |
Full upper denture | ADA Code: D5110 | Usual Fee1: $1975.00 | With Plan2: $752 | You Save: $1,223 | Saving Percentage: 62% |
Full lower denture | ADA Code: D5120 | Usual Fee1: $1988.00 | With Plan2: $755 | You Save: $1,233 | Saving Percentage: 62% |
Add clasp to existing partial denture | ADA Code: D5660 | Usual Fee1: $237.00 | With Plan2: $118 | You Save: $119 | Saving Percentage: 50% |
Surgical placement of implant body: endosteal implant | ADA Code: D6010 | Usual Fee1: $2086.00 | With Plan2: 20% Off | You Save: $417.20* | Saving Percentage: 20% |
Abutment supported cast metal crown (predominantly base metal) | ADA Code: D6063 | Usual Fee1: $1338.00 | With Plan2: 20% Off | You Save: $267.60* | Saving Percentage: 20% |
Implant supported crown high noble alloys | ADA Code: D6067 | Usual Fee1: $1638.00 | With Plan2: 20% Off | You Save: $327.60* | Saving Percentage: 20% |
Tooth replacement part of permanent bridge | ADA Code: D6210 | Usual Fee1: $1400.00 | With Plan2: 20% Off | You Save: $280.00* | Saving Percentage: 20% |
Single tooth removal - simple extraction | ADA Code: D7140 | Usual Fee1: $215.00 | With Plan2: $71 | You Save: $144 | Saving Percentage: 67% |
Extraction - impacted wisdom tooth (soft tissue) | ADA Code: D7220 | Usual Fee1: $402.00 | With Plan2: $128 | You Save: $274 | Saving Percentage: 68% |
Extraction - impacted wisdom tooth (partial bony) | ADA Code: D7230 | Usual Fee1: $484.00 | With Plan2: $164 | You Save: $320 | Saving Percentage: 66% |
Comprehensive orthodontic treatment of the transitional dentition | ADA Code: D8070 | Usual Fee1: $5562.00 | With Plan2: 20% Off | You Save: $1112.40* | Saving Percentage: 20% |
Full orthodontic child treatment (braces) | ADA Code: D8080 | Usual Fee1: $5658.00 | With Plan2: $2,562 | You Save: $3,096 | Saving Percentage: 55% |
Full orthodontic adult treatment (braces) | ADA Code: D8090 | Usual Fee1: $5936.00 | With Plan2: $2,615 | You Save: $3,321 | Saving Percentage: 56% |
External bleaching – per arch – performed in office | ADA Code: D9972 | Usual Fee1: $250.00 | With Plan2: 20% Off | You Save: $50.00* | Saving Percentage: 20% |
External bleaching - per tooth | ADA Code: D9973 | Usual Fee1: $185.00 | With Plan2: 20% Off | You Save: $37.00* | Saving Percentage: 20% |
Internal bleaching - per tooth | ADA Code: D9974 | Usual Fee1: $250.00 | With Plan2: 20% Off | You Save: $50.00* | Saving Percentage: 20% |
* Savings will be 20% off usual customary rate.
Included in your Careington Care 500 Series plan is a vision benefit through VSP Vision Savings Pass®, which will provide you with access to savings regarding your vision care needs.
VSP Vision Savings Pass is a discount program that offers savings on eye care and eyewear. With the best choices in eyewear, VSP makes it easy to find the perfect frame that’s right for you. Choose from great brands like Anne Klein, bebe®, Calvin Klein, Flexon®, Lacoste, Nike, Nine West, and more.1
Description | Cost Without VSP2 | Discount | |
---|---|---|---|
WellVision Exam4 | $90 | $50 | $50* |
Ann Klein Frames3 | $179.99 | $135 | 25% |
Single Vision Lens | $90 | $40 | 55% |
Anti-Reflective Coating | $113 | $84.75 | 25% |
Notes:
Service |
---|
WellVision Exam® |
Retinal Screening |
Lenses |
Lens Enhancements |
Frames |
Sunglasses |
Contact Lenses |
Laser Vision Correction |
This plan is not insurance.
Not available in WA.
Included in your Careington Care 500 Series plan is a Lasik surgery savings benefit through QualSight, which provides you with access to savings regarding Lasik vision correction.
Members will receive savings of 40% to 50% off the overall national average cost for Traditional LASIK surgery through QualSight. Members can receive significant savings on newer procedures like Custom Bladeless (all laser) LASIK .
Vision Care Savings at a Glance
The cost of Traditional LASIK is $935 per eye and Custom LASIK is $1360 per eye with QualSight, which is the total cost with no hidden extra fees.
*Careington does not refund the partial payment. Refund provided by QualSight.
The QyalSight program is not an insured program.
Product not available in MT
Included in your Careington 500 Series membership is a prescription drug benefit through Agelity, which provides access to savings regarding your prescription medication needs.
Receive access to savings on the following benefits:
*Discounts available at participating pharmacies only