Dental Access Savings Estimates

Each dentist has a different price list, but we took averages from Los Angeles, Orlando, Chicago and New York City to give you an idea of what you’ll save.

ADA Aetna Navigator Description Usual Fee Discounted Fee Member Savings
D0120 Periodic Oral Exam

$73 $35 $38
D0150 Comprehensive Oral Exam

$113 $49 $64
D0210 X-Ray

Intraoral - complete series including bitewings

$168 $87 $81
D0274 X-Ray

Bitewings - Four Films

$82 $41 $41
D0330 X-Ray

Panoramic Film

$145 $73 $72
D1110 Cleaning

(Prophylaxis) - Adult

$127 $68 $59
D1120 Cleaning

(Prophylaxis) - Child

$93 $51 $42
D1351 Sealant

Per Tooth

$74 $36 $38
D2330 Filling

1-surface resin (white) filling, front (anterior) tooth

$204 $102 $102
D2750 Crown

Porcelain fused to high noble metal (i.e. gold)

$1,312 $829 $483
D2752 Restorative Crown

Porcelain fused to noble metal

$1,306 $787 $519
D3310 Root Canal

Front Tooth (Anterior) Excluding Final Restoration

$880 $536 $344
D3320 Root Canal

Premolar tooth (bicuspid) excluding final restoration

$987 $638 $349
D3330 Root Canal

Molar, excluding final restoration

$1,226 $859 $367
D4260 Osseous Surgery

Four or more contiguous teeth - modifies bony support of teeth

$1,175 $853 $322
D4341 Scaling/Root Planing

Four or more contiguous teeth

$274 $160 $114
D4910 "Periodontal Maintenance

For patients who have been previously treated for periodontal disease

$171 $91 $80
D5110 Complete Upper Denture

(Maxillary)

$1,441 $1,003 $438
D7140 Extraction

Erupted tooth or exposed root-includes local anaesthesia and suturing if needed

$229 $101 $128
D8080 Comprehensive Orthodontic Treatment

(Child)

$5,952 $3,484 $2,468
Aetna Navigator Description
ADA Usual Fee Discounted Fee Member Savings
Periodic Oral Exam

D0120 $73 $35 $38
Comprehensive Oral Exam

D0150 $113 $49 $64
X-Ray

Intraoral - complete series including bitewings

D0210 $168 $87 $81
X-Ray

Bitewings - Four Films

D0274 $82 $41 $41
X-Ray

Panoramic Film

D0330 $145 $73 $72
Cleaning

(Prophylaxis) - Adult

D1110 $127 $68 $59
Cleaning

(Prophylaxis) - Child

D1120 $93 $51 $42
Sealant

Per Tooth

D1351 $74 $36 $38
Filling

1-surface resin (white) filling, front (anterior) tooth

D2330 $204 $102 $102
Crown

Porcelain fused to high noble metal (i.e. gold)

D2750 $1312 $829 $483
Restorative Crown

Porcelain fused to noble metal

D2752 $1306 $787 $519
Root Canal

Front Tooth (Anterior) Excluding Final Restoration

D3310 $880 $536 $344
Root Canal

Premolar tooth (bicuspid) excluding final restoration

D3320 $987 $638 $349
Root Canal

Molar, excluding final restoration

D3330 $1226 $859 $367
Osseous Surgery

Four or more contiguous teeth - modifies bony support of teeth

D4260 $1175 $853 $322
Scaling/Root Planing

Four or more contiguous teeth

D4341 $274 $160 $114
"Periodontal Maintenance

For patients who have been previously treated for periodontal disease

D4910 $171 $91 $80
Complete Upper Denture

(Maxillary)

D5110 $1441 $1003 $438
Extraction

Erupted tooth or exposed root-includes local anaesthesia and suturing if needed

D7140 $229 $101 $128
Comprehensive Orthodontic Treatment

(Child)

D8080 $5952 $3484 $2468

In addition to the above procedures, your plan will also save on dental work like implants, veneers, bone grafts, ceramic crowns, adult braces, and more!

Actual costs and savings may vary by provider, service and geographic location. We use the average of negotiated fees from participating providers to determine the average costs, as shown on the chart.

The select regional average cost represents the average fees for the procedures listed above in Los Angeles, Orlando, Chicago and New York City, as displayed in the cost of care tool as of June 2020.

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THIS PLAN IS NOT INSURANCE and is not intended to replace health insurance. This plan does not meet the minimum creditable coverage requirements under M.G.L. c.111M and 956 CMR 5.00. This plan is not a Qualified Health Plan under the Affordable Care Act. This is not a Medicare prescription drug plan. The range of discounts will vary depending on the type of provider and service. The plan does not pay providers directly. Plan members must pay for all services but will receive a discount from participating providers.The list of participating providers is at https://my.1dental.com/dentists A written list of participating providers is available upon request. You may cancel within the first 30 days after effective date or receipt of membership materials (whichever is later) and receive a full refund, less a nominal processing fee (nominal fee for MD residents is $5, AR and TN residents will be refunded processing fee). Discount Plan Organization and administrator: Careington International Corporation, 7400 Gaylord Parkway, Frisco, TX 75034; phone 800-441-0380.

This plan is not available in Vermont or Washington.