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Sample Saving
| Procedure | ADA Code | Fee* | With Cigna** | You Save | % |
|---|---|---|---|---|---|
| Two periodic Exams | D0120 | $102 | $70 | $32 | 31.5% |
| Two routine cleanings (adult) | D1110 | $180 | $123 | $57 | 31.5% |
| Two routine cleanings (child) | D1120 | $138 | $95 | $43 | 31.5% |
| Two fluoride treatments (child) | D1203 | $72 | $49 | $23 | 31.5% |
| Two bitewing x-rays | D0274 | $86 | $59 | $27 | 31.5% |
| One resin composite filling (1-surface anterior,adult or child) | D2330 | $155 | $105 | $50 | 32.0% |
| Two quadrants periodontal scaling and root planning | D4342 | $466 | $317 | $149 | 32.0% |
| One complete denture | D5110 | $1,318 | $921 | $397 | 30.2% |
| Total-average | N/A | $291 | $201 | $90 | 30.9% |
Sample Savings are based on General Dentist Fees. Dental Fees for this program vary by Dentist.
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