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Preventative Care

Dental Code

77070 AVG No Insurance

OASIS No Insurance

Adult Checkup (exam & cleaning)

Child Checkup (exam & cleaning)

Emergency Appt. -Limited Exam & X-ray

X-ray -Bitewings 2x

X-ray -Bitewings 4x

X-ray -Panaramic

2-D Intra-oral Images (as needed)

Prophylaxis -Adult

Prophylaxis -Child

Fluoride Varnish

Fluoride -w/o Varnish

Dental Sealant

D0120, D1110

D0120, D1120

D0140, D0220

D0272

D0274

D0330

D0350

D1110

D1120

D1206

D1208

D1351

$280

$254

$170

$73

$98

$73

$102

$140

$114

$70

$59

$88

$170

$150

$75

$20

$30

$65

No Charge

$95

$75

$20

$15

$69

RESTORATIVE DENTISTRY

Dental Code

77070 AVG No Insurance

OASIS No Insurance

White Composite Filling 1
Surface Anterior

White Composite Filling 2
Surface Anterior

White Composite Filling 3
Surface Anterior

White Composite Filling 4
Surface Anterior

White Composite Filling 1
Surface Anterior

White Composite Filling 2
Surface Anterior

White Composite Filling 3
Surface Anterior

White Composite Filling 4
Surface Anterior

Porcelain Crown

D2330

D2331

D2332

D2335

D2391

D2392

D2393

D2394

D2740

$241

$292

$352

$450

$263

$330

$411

$495

$1,673

$220

$266

$326

$408

$241

$303

$376

$442

$1,462

ENDODONTICS

Dental Code

77070 AVG No Insurance

OASIS No Insurance

Root Canal Front Tooth

Root Canal Premolar

Root Canal Molar(back tooth)

D3310

D3320

D3330

$1,149

$1,300

$1,535

$1,108

$1,255

$1,500

PERIODONTICS

Dental Code

77070 AVG No Insurance

OASIS No Insurance

Deep Cleaning (per quadrant) also known as Scaling and Root Planing 4 or more Teeth

Deep Cleaning (per quadrant) also known as Scaling and Root Planing 1-3 Teeth

D4341

D4342

$361

$291

$250

$190

PROSTHODONTICS

Dental Code

77070 AVG No Insurance

OASIS No Insurance

Complete Upper Denture

Complete Lower Denture

Partial Upper Denture (All Resin)

Partial Lower Denture (All Resin)

Partial Upper Denture (Metal Frame)

Partial Lower Denture (Metal Frame)

D5110

D5120

D5211

D5212

D5213

D5214

$2,249

$2,269

$2,097

$2,097

$2,394

$2,394

$2,200

$2,200

$2,695

$2,695

$2,200

$2,200

IMPLANT DENTISTRY

Dental Code

77070 AVG No Insurance

OASIS No Insurance

Dental Implant (pt.1)

Dental Implant (pt.2) Abutment

Dental Implant (pt.3) Crown

Dental Implant/Abutment/Crown

D6010

D6057

D6058

D6010, D6057, D6058

$2,915

$1,320

$1,985

$6,220

$1,800

$900

$1,300

$4,000

ORAL SURGERY

Dental Code

77070 AVG No Insurance

OASIS No Insurance

Surgical Extraction

Extraction Impacted Soft Tissue

Extraction Impacted Partially Bony

Extraction Impacted Complete Bony

D7210

D7220

D7230

D7240

$409

$482

$595

$728

$375

$412

$516

$632

OTHERS

Dental Code

77070 AVG No Insurance

OASIS No Insurance

Bone Replacement -Ridge Preservation per Site

Orthodontic Care Clear Aligners Case Dependent

Orthodontic Care Traditional Braces Case Dependent

Nitrous Sedation

Night/Occlusal Guard

In-office Professional Whitening

D7953

D8090, D8080

D8090, D8080

D9230

D9944

D9972

$2,916

Not available

Not available

$130

$845

$471

$887

$4,699-$6,699

$3,699-$5699

$25

$465

$350

All average zip code fees shown are based on 2025 data from Fair Health Consumer, a nonprofit organization that collects and publishes independent healthcare cost information to help consumers make informed decisions. To learn more, please visit www.fairhealthconsumer.org — due to laws governing nonprofit organizations, we are unable to provide a clickable link, but you can copy and paste the address into your browser. OASIS fees are current as of 2025 and reflect pricing for uninsured patients enrolled in our Simply Smile savings plan. There is no cost to join or maintain membership in the Simply Smile plan—it’s simply our way of making quality dentistry more affordable

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