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
$72-$155
Periodic Exam (D0120) - $72
Limited Exam (D0140) - $115
Exam < 3 years old (D0145) - $104
New Patient Exam (D0150) - $127
Perio Exam (D0180) - $155
Teeth Cleaning (Prophylaxis)
$93-$134
Adult Teeth Cleaning (D1110) - $134
Child Teeth Cleaning (D1120) - $93
Sealants (D1351)
$76
Amalgam (Silver) Fillings
$188-$300
1 Surface (D2140) - $188
2 Surfaces (D2150) - $221
3 Surfaces (D2160) - $252
4+ Surfaces (D2161) - $300
Composite (White) Anterior Fillings
$233-$433
1 Surface (D2330) - $233
2 Surfaces (D2331) - $283
3 Surfaces (D2332) - $345
4+ Surfaces (D2335) - $433
Composite (White) Posterior Fillings
$251-$465
1 Surface (D2391) - $251
2 Surfaces (D2392) - $319
3 Surfaces (D2393) - $396
4+ Surfaces (D2394) - $465
Osseous Surgery
$1,400-$1,730
1-3 Teeth (D4261) - $1,400
Quad (D4260) - $1,730
Tissue Graft (D4273)
$1,555
Scaling & Root Planing
$283-$375
1-3 Teeth (D4342) - $283
Quad (D4341) - $375
Periodontal Maintenance (D4910)
$201
Restorative Dental
Certain insurance plans may cover up to 100%
Dental Crowns
$412-$1,628
Crown - Porcelain/Ceramic (D2740) - $1,628
Crown - Porcelain Fused to Metal (D2750) - $1,628
Crown Build Up (D2950) - $412
Root Canal
$1,133-$1,648
Anterior (D3310) - $1,133
Bicuspid (D3320) - $1,442
Molar (D3330) - $1,648
Dentures
$2,594-$2,651
Partial Upper Denture (D5213) - $2,651
Partial Lower Denture (D5214) - $2,651
Complete Upper Denture (D5110) - $2,594
Complete Lower Denture (D5120) - $2,594
Dental Bridges
$1,624
Retainer - Porcelain/Ceramic (D6740) - $1,624
Pontic - Porcelain/Ceramic (D6245) - $1,624
Dental Implants
$1,249-$2,575
Custom Abutment (D6057) - $1,249
Implant Crown - Porcelain/Ceramic (D6058) - $1,918
Surgical Place Implant (D6010) - $2,575
Tooth Extractions
$283-$416
Simple Extraction (D7140) - $283
Surgical Extraction (D7210) - $416
Sinus Augmentation (D7952)
$1,545
Augmentation w/Bone (D7951) - $2,575
Bone Graft
$809
w/Implant (D6104) - $809
w/Extraction Only (D7953) - $809
Additional Services
Certain insurance plans may cover up to 100%
Fluoride (D1206)
$60
Dental X-rays
$36-$185
FMX (D0210) - $180
PA (D0220) - $41
Addt’l PAs (D0230) - $36
2 BWX (D0272) - $62
4 BWX (D0274) - $93
Panoramic X-ray (D0330) - $185
