Sample General                         Dental Office Fees         AmeriPlan®         AmeriPlan®   
   Dentist Procedures                                  Up To*                     Fees                   Savings 
                                                                                                                                             
Periodic Oral Exam                                           $60                      $12                        80% 

Initial Oral Exam                                                $103                    $30                        71% 

X-Ray: Intraoral Complete Series                  $143                    $50                        65% 

X-Ray: Panoramic                                             $117                    $50                        57% 
 
Regular Teeth Cleaning                                  $103                    $38                        63%

Amalgam Filling -  1 Surface                          $152                     $45                        70% 

Amalgam Filling -  2 Surface                          $199                     $65                        67%

Resin Based composite - 1 Surface            $176                      $60                       66% 

Resin Based Composite - 2 Surface           $218                      $85                       61% 

Porcelain Crown with High Noble Metal      $1,192                  $525                     56% 

Root Canal Anterior                                         $788                       $350                     56% 

Root Canal Bicuspid                                       $901                       $375                     58% 

Deep Teeth Cleaning                                      $216                       $90                       58% 

Orthodontic Braces by General dentist
          children under age 19                           $4,500                    $2,000                 56% 

Orthodontic Braces by General dentist 
          adult 19 and over                                   $5,000                    $2,200                 56%


Fees may be different depending on where you live.

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