Procedure | ADA Code | Usual Fee1 | With Plan2 | You Save | % Saved |
---|---|---|---|---|---|
Routine 6 month check-up | ADA Code: D0120 | Usual Fee1: $51.00 | With Plan2: $43 | You Save: $8 | Saving Percentage: 16% |
In depth check-up | ADA Code: D0150 | Usual Fee1: $86.00 | With Plan2: $70 | You Save: $16 | Saving Percentage: 19% |
Full mouth x-rays | ADA Code: D0210 | Usual Fee1: $143.00 | With Plan2: $103 | You Save: $40 | Saving Percentage: 28% |
Four bitewing x-rays | ADA Code: D0274 | Usual Fee1: $72.00 | With Plan2: $60 | You Save: $12 | Saving Percentage: 17% |
Panoramic film | ADA Code: D0330 | Usual Fee1: $115.00 | With Plan2: $94 | You Save: $21 | Saving Percentage: 18% |
Adult teeth cleaning | ADA Code: D1110 | Usual Fee1: $90.00 | With Plan2: $77 | You Save: $13 | Saving Percentage: 14% |
Child teeth cleaning | ADA Code: D1120 | Usual Fee1: $66.00 | With Plan2: $57 | You Save: $9 | Saving Percentage: 14% |
Protective sealant / tooth | ADA Code: D1351 | Usual Fee1: $56.00 | With Plan2: $43 | You Save: $13 | Saving Percentage: 23% |
1 surface silver filling for primary or permanent tooth | ADA Code: D2140 | Usual Fee1: $149.00 | With Plan2: $115 | You Save: $34 | Saving Percentage: 23% |
1 surface white filling for u or l front tooth | ADA Code: D2330 | Usual Fee1: $185.00 | With Plan2: $144 | You Save: $41 | Saving Percentage: 22% |
Single crown - porcelain on high noble metal | ADA Code: D2750 | Usual Fee1: $1139.00 | With Plan2: $906 | You Save: $233 | Saving Percentage: 20% |
Single crown - porcelain on noble metal | ADA Code: D2752 | Usual Fee1: $1029.00 | With Plan2: $872 | You Save: $157 | Saving Percentage: 15% |
Core build-up with pins | ADA Code: D2950 | Usual Fee1: $285.00 | With Plan2: $230 | You Save: $55 | Saving Percentage: 19% |
Root canal treatment - front tooth | ADA Code: D3310 | Usual Fee1: $789.00 | With Plan2: $610 | You Save: $179 | Saving Percentage: 23% |
Root canal treatment - bicuspid | ADA Code: D3320 | Usual Fee1: $937.00 | With Plan2: $724 | You Save: $213 | Saving Percentage: 23% |
Root canal treatment - molar | ADA Code: D3330 | Usual Fee1: $1195.00 | With Plan2: $869 | You Save: $326 | Saving Percentage: 27% |
Perio scaling and root planing (per quadrant) | ADA Code: D4341 | Usual Fee1: $277.00 | With Plan2: $213 | You Save: $64 | Saving Percentage: 23% |
Regular cleaning following periodontic procedure | ADA Code: D4910 | Usual Fee1: $150.00 | With Plan2: $116 | You Save: $34 | Saving Percentage: 23% |
Full upper denture | ADA Code: D5110 | Usual Fee1: $1532.00 | With Plan2: $1,286 | You Save: $246 | Saving Percentage: 16% |
Full lower denture | ADA Code: D5120 | Usual Fee1: $1500.00 | With Plan2: $1,303 | You Save: $197 | Saving Percentage: 13% |
Add clasp to existing partial denture | ADA Code: D5660 | Usual Fee1: $261.00 | With Plan2: $222 | You Save: $39 | Saving Percentage: 15% |
Single tooth removal - simple extraction | ADA Code: D7140 | Usual Fee1: $174.00 | With Plan2: $148 | You Save: $26 | Saving Percentage: 15% |
Extraction - impacted wisdom tooth (soft tissue) | ADA Code: D7220 | Usual Fee1: $330.00 | With Plan2: $267 | You Save: $63 | Saving Percentage: 19% |
Extraction - impacted wisdom tooth (partial bony) | ADA Code: D7230 | Usual Fee1: $415.00 | With Plan2: $331 | You Save: $84 | Saving Percentage: 20% |
The sample table above is a small selection of common procedures discounted by the Aon Dental Solutions Plan. You will be provided with a complete fee schedule with discounted fees for nearly every dental procedure once you join. All procedures covered under the Aon Dental Solutions Plan offer similar savings to the sample above. If you are looking for a specific dental procedure that is not on this sample, please contact our Customer Care Center toll-free at (888) 632-5353 with the ADA Code of the procedure and we can provide the discounted fee.
1 The [“Usual Fee”] is determined by DentalPlans.com, Inc., using benchmark data from FAIR Health, Inc. FAIR Health data is used under license. Fees may reflect combined fees from several different procedures into one procedure and may not be directly comparable to a specific benchmark in FAIR Health Data. Actual fees charged by your provider may vary for a variety of reasons.
2 Discounted fees are listed for visits to a participating general dentist. Any procedure not listed on the complete fee schedule (provided in your Member's Area once you join) will be discounted 20% off the provider's usual and customary fee. Consult with your provider prior to beginning any treatment. Lab fees are additional.
* Savings will be 20% off usual customary rate.