Savings to Smile About
Below is a list of common dental services and what you’ll pay with Perfect Teeth Savings Plan.
| Savings Summary | ||
|---|---|---|
| ADA Code | Procedure Description | Member Pays* |
| Preventive & Diagnostic | ||
| 0120 | Periodic Exam | NO CHARGE |
| 0140 | Limited Exam - Problem Focused | NO CHARGE |
| 0150 | Comprehensive Exam | NO CHARGE |
| 0210 | Full Mouth X-Rays | NO CHARGE |
| 0330 | Panoramic X-Rays | NO CHARGE |
| 0431 | Oral Cancer Screening | NO CHARGE |
| 1110 | Adult Cleaning | 30% OFF |
| 1120 | Child Cleaning | 30% OFF |
| Restorative | ||
| 2330 | Filling - 1 Surface, Anterior | 30% OFF |
| 2391 | Filling - 1 Surface, Posterior | 30% OFF |
| 2740 | Crown - Porcelain/Ceramic | 30% OFF |
| Endodontics & Periodontics | ||
| 3310 | Root Canal - Anterior | 30% OFF |
| 3330 | Root Canal - Molar | 30% OFF |
| 4910 | Periodontal Maintenance | 30% OFF |
| Prosthodontics & Oral Surgery | ||
| 7140 | Simple Extraction | 30% OFF |
| 7210 | Surgical Extraction | 30% OFF |
*Member savings may vary by location. Free exams and x-rays limited to 2x per member/per annual membership term.