Savings to Smile About
Below is a list of common dental services and what you’ll pay with Absolute Dental Plan.
| ADA Code | Procedure Description | Member Pays* |
|---|---|---|
| Preventive & Diagnostic | ||
| D0120 | Periodic Exam | No Charge |
| D0140 | Limited Exam - Problem Focused | No Charge |
| D0210 | Full Mouth X-Rays | 37% Off |
| D0150 | Comprehensive Exam | 37% Off |
| D1110 | Adult Cleaning | 37% Off |
| D1120 | Child Cleaning | 37% Off |
| D1206 | Fluoride - Including Varnish | 37% Off |
| D1351 | Sealant - Per Tooth | 37% Off |
| Restorative | ||
| D2392 | Filling - 2 Surface, Posterior | 37% Off |
| D2740 | Crown - Porcelain/Ceramic | 37% Off |
| Endodontics & Periodontics | ||
| D3310 | Root Canal - Anterior | 37% Off |
| D4341 | Perio Scaling/Root Planing - 4+ Teeth | 37% Off |
| D4910 | Periodontal Maintenance | 37% Off |
| Prosthodontics & Oral Surgury | ||
| D7140 | Simple Extraction | 37% Off |
| D7210 | Surgical Extraction | 37% Off |
*Member savings vary by location. Free Limited and Periodic Exams and X-rays Limit 2 per Year