Office Fees
Maynard Family Dentists Dental Service Fees
Giving You the Full Picture
At Maynard Family Dentists, we put you at the center of everything we do, which means being as transparent as possible about not only who we are and the services we offer, but also about how our fees are structured. We’ve listed most of our services with fee structures below. Please understand that each procedure could vary in price from these numbers depending on the need—every patient and every case is different.
Preventative Care
Certain insurance plans may cover up to 100%
Dental Exam
$78-$150
Periodic Exam (D0120) - $78
Limited Exam (D0140) - $113
Exam < 3 years old (D0145) - $100
New Patient Exam (D0150) - $127
Perio Exam (D0180) - $150
Teeth Cleaning (Prophylaxis)
$97-$162
Adult Teeth Cleaning (D1110) - $162
Child Teeth Cleaning (D1120) - $97
Sealants (D1351)
$87
Amalgam (Silver) Fillings
$183-$346
1 Surface (D2140) - $183
2 Surfaces (D2150) - $226
3 Surfaces (D2160) - $271
4+ Surfaces (D2161) - $346
Composite (White) Anterior Fillings
$208-$400
1 Surface (D2330) - $208
2 Surfaces (D2331) - $255
3 Surfaces (D2332) - $304
4+ Surfaces (D2335) - $400
Composite (White) Posterior Fillings
$223-$410
1 Surface (D2391) - $223
2 Surfaces (D2392) - $287
3 Surfaces (D2393) - $354
4+ Surfaces (D2394) - $410
Osseous Surgery
$1,250-$1,650
1-3 Teeth (D4261) - $1,250
Quad (D4260) - $1,650
Tissue Graft (D4273)
$1,510
Scaling & Root Planing
$253-$337
1-3 Teeth (D4342) - $253
Quad (D4341) - $337
Periodontal Maintenance (D4910)
$177
Restorative Dental
Certain insurance plans may cover up to 100%
Dental Crowns
$450-$1,640
Crown - Porcelain/Ceramic (D2740) - $1,640
Crown - Porcelain Fused to Metal (D2750) - $1,604
Crown Build Up (D2950) - $450
Root Canal
$1,100-$1,600
Anterior (D3310) - $1,100
Bicuspid (D3320) - $1,400
Molar (D3330) - $1,600
Dentures
$2,900
Partial Upper Denture (D5213) - $2,900
Partial Lower Denture (D5214) - $2,900
Complete Upper Denture (D5110) - $2,900
Complete Lower Denture (D5120) - $2,900
Dental Bridges
$1,614-$1,712
Retainer - Porcelain/Ceramic (D6740) - $1,712
Pontic - Porcelain/Ceramic (D6245) - $1,614
Dental Implants
$1,106-$2,450
Custom Abutment (D6057) - $1,106
Implant Crown - Porcelain/Ceramic (D6058) - $1,896
Surgical Place Implant (D6010) - $2,450
Tooth Extractions
$250-$387
Simple Extraction (D7140) - $250
Surgical Extraction (D7210) - $387
Sinus Augmentation (D7952)
$1,500
Augmentation w/Bone (D7951) - $2,500
Bone Graft
$785
w/Implant (D6104) - $785
w/Extraction Only (D7953) - $785
Additional Services
Certain insurance plans may cover up to 100%
Fluoride (D1206)
$55
Dental X-rays
$36-$180
FMX (D0210) - $180
PA (D0220) - $42
Addt’l PAs (D0230) - $36
2 BWX (D0272) - $73
4 BWX (D0274) - $115
Panoramic X-ray (D0330) - $163
