Fees for Top 15 Procedures*
Per Colorado State Senate Bill (SB) 65, dental offices are now required to publish a list of cash pay fees for their top fifteen most common procedures.
1. Periodic Oral Examination (D0120) $59.00
2. Adult Prophylaxis-Cleaning(D1110) $111.00
3. Child Prophylaxis-Cleaning (D1120) $75.00
4. Bitewing Radiographs-4 films (D0274) $72.00
5. Periapical Radiograph-1 film (D0220) $34.00
6. Limited Exam-Problem Focused (D0140) $69.00
7. Comprehensive Oral Examination (D0150) $99.00
8. Panoramic Radiograph (D0330) $129.00
9. Topical Fluoride (D1208) $29.00
10. Sealant – per tooth (D1351) $67.00
11. Anterior Composite Filling-4 Surface (D2335) $388.00
12. Anterior Composite Filling-3 Surface (D2332) $303.00
13. Posterior Composite Filling-3 Surface (D2393) $334.00
14. Surgical Extraction (D7210) $327.00
15. Palliative Treatment (D9110) $143.00
* The health care price listed for any given health care service is an estimate. Actual charges for the health care service are dependent on the circumstances, including any complications or exceptional treatment, at the time the service is rendered.
If you are covered by Health insurance or a dental plan, you are strongly encouraged to consult with your insurer or plan to determine accurate information about your financial responsibility for a particular health care service provided by a health care provider at this office. If you are not covered by health insurance or a dental plan, you are strongly encouraged to contact our billing department at 719-598-6966 to discuss payment options prior to receiving a health care service from a health care provider at this office since posted health care prices may not reflect the actual amount of your financial responsibility.