Office Fees
Giving You the Full Picture
At Lakeview 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
$65-$150
Periodic Exam (D0120) - $65
Limited Exam (D0140) - $112
Exam < 3 years old (D0145) - $101
New Patient Exam (D0150) - $132
Perio Exam (D0180) - $150
Teeth Cleaning (Prophylaxis)
$104-$125
Adult Teeth Cleaning (D1110) - $125
Child Teeth Cleaning (D1120) - $104
Sealants (D1351)
$79
Amalgam (Silver) Fillings
$183-$324
1 Surface (D2140) - $183
2 Surfaces (D2150) - $215
3 Surfaces (D2160) - $260
4+ Surfaces (D2161) - $324
Composite (White) Anterior Fillings
$212-$412
1 Surface (D2330) - $212
2 Surfaces (D2331) - $260
3 Surfaces (D2332) - $310
4+ Surfaces (D2335) - $412
Composite (White) Posterior Fillings
$222-$422
1 Surface (D2391) - $222
2 Surfaces (D2392) - $287
3 Surfaces (D2393) - $350
4+ Surfaces (D2394) - $422
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-$321
1-3 Teeth (D4342) - $253
Quad (D4341) - $321
Periodontal Maintenance (D4910)
$174
Restorative Dental
Certain insurance plans may cover up to 100%
Dental Crowns
$405-$1,620
Crown - Porcelain/Ceramic (D2740) - $1,620
Crown - Porcelain Fused to Metal (D2750) - $1,538
Crown Build Up (D2950) - $405
Root Canal
$1,100-$1,600
Anterior (D3310) - $1,100
Bicuspid (D3320) - $1,400
Molar (D3330) - $1,600
Dentures
$1,896-$1,910
Partial Upper Denture (D5213) - $1,896
Partial Lower Denture (D5214) - $1,999
Complete Upper Denture (D5110) - $1,928
Complete Lower Denture (D5120) - $1,910
Dental Bridges
$1,583
Retainer - Porcelain/Ceramic (D6740) - $1,583
Pontic - Porcelain/Ceramic (D6245) - $1,583
Dental Implants
$2,450
Custom Abutment (D6057) - $963
Implant Crown - Porcelain/Ceramic (D6058) - $1,495
Surgical Place Implant (D6010) - $2,450
Tooth Extractions
$231-$387
Simple Extraction (D7140) - $231
Surgical Extraction (D7210) - $387
Non-Surgical Extraction- $231
Sinus Augmentation (D7952)
$1,500
Augmentation w/Bone (D7951) - $2,329
Bone Graft
$785
w/Implant (D6104) - $785
w/Extraction Only (D7953) - $785
Additional Services
Certain insurance plans may cover up to 100%
Fluoride (D1206)
$58
Dental X-rays
$35-$179
FMX (D0210) - $179
PA (D0220) - $40
Addt’l PAs (D0230) - $35
2 BWX (D0272) - $65
4 BWX (D0274) - $91
Panoramic X-ray (D0330) - $171
