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Careington Maximum Care Dental Network (PPO, CPPO & Dentemax)
|Procedure Description||Regular Cost*||Plan Cost**||Savings Amount||Savings Percent|
|Extensive Oral Exam||$149||$64||$85||57%|
|Four Bitewing X-Rays||$94||$47||$47||50%|
|Composite (White) Filling (front teeth)||$220||$113||$107||49%|
|Crown (porcelain fused to noble metal)||$1,557||$851||$706||45%|
|Molar Root Canal||$1,535||$818||$717||47%|
|Complete Upper Denture||$2,273||$1,165||$1,108||49%|
|Extraction (single tooth)||$282||$125||$157||56%|
*Regular Cost is based on the average 80th percentile usual and customary rates as detailed in the 2021 Fair Health Report for the Los Angeles, Orlando, Chicago & NYC metropolitan statistical area(s).
**Plan Cost represents the average of the assigned Maximum Care PPO plan fees for the Los Angeles, Orlando, Chicago & NYC metropolitan statistical area(s).
Prices subject to change.
This is a PPO plan. This is not a discount plan.
Coverage is paid according the plan design. Please review your policy for coverage details. All applicable co-pays, deductibles or co-insurance, outlined by the plan design, are to be paid directly to the dental office at the time service is rendered. Please ask the dentist or office staff to explain all charges before treatment begins.
DN11 - 2/10/22