Northeast Specialist
Fee Schedule

Last Printing April 2002


 

ENDODONTIST NDPA FEE USUAL FEE
Initial Consultation $40.00 $90.00
Pulp Capping $80.00 $135.00
Pulpotomy $110.00 $180.00
Root Canal Therapy
(excluding final restoration)
Anterior $445.00 $675.00
Bicuspid $535.00 $790.00
Molar $645.00 $960.00
Apicoectomy - (first root-per tooth) $350.00 $580.00
Each additional root $215.00 $310.00
Retrograde filling per-root $150.00 $235.00
Root Resection - per root (HEMISECTION) $285.00 $390.00
Incision and Drainage $135.00 $220.00
*Root canal treatment fees include filling the canals. It does not include final restorations ( which are sometimes called fillings)
*Retreatment of a Root Canal is performed at 25% courtesy fee

horizontal rule

 

ORAL SURGEON NDPA FEE USUAL FEE


 
Initial Consultation $40.00 $85.00
Simple Extraction (single tooth) $80.00 $145.00
Simple Extraction (each additional tooth) $65.00 $117.00
Surgical Extraction $130.00 $215.00
Soft Tissue Impaction $160.00 $255.00
Partial Bony Impaction $230.00 $335.00
Full Bony Impaction $325.00 $440.00
Full Bony Impaction
with unusual surgical complications
$395.00 $825.00
Panarex $50.00 $100.00
General Anesthesia - first unit $95.00 $205.00
(additional 15minutes) $55.00 $170.00

horizontal rule

 

ORTHODONTIST NDPA FEE USUAL FEE
initial Consultation $40.00 $90.00
Diagnosis/Records
Work-up, including full mouth series, Models, Photographs and a second visit for discussion and presentation
$140.00 $280.00
Class I Malocclusion
(comprehensive dentition)
$3100.00 $4550.00
Class II Malocclusion
(comprehensive dentition)
$3450.00 $4850.00
Class III - available at 15% off Dentist's usual fee
Post-Treatment Stabilization - each retainer $200.00 $300.00
Partial Case - Evaluated on an individual basis
**Specialist's Initial Consultation fee will be applied towards Diagnosis/Records unless performed as a separate visit

 

horizontal rule

 

PERIODONTIST NDPA FEE USUAL FEE
initial Consultation $40.00 $90.00
Diagnosis/Records/Charting
including 5 or more x-rays $130.00 $245.00
including 4 x-rays or less $115.00 $185.00
Periodontal Scaling/per quadrant
(root planing - curettage)
$155.00 $210.00
Scaling (full mouth) $115.00 $160.00
Gingivectomy or gingivoplasty - per tooth $140.00 $190.00
Gingivectomy or gingivoplasty - per quadrant $415.00 $550.00
Gingival flap procedure
(including root planing - per quadrant)
$490.00 $640.00
Osseous Surgery
(including flap entry and closure) per quadrant
$675.00 $880.00
Pedicle soft tissue graft procedure $435.00 670.00
Free Soft Tissue Graft Procedure
(including donor site)
$455.00 $690.00
Apically repositioned flap procedure $500.00 $690.00
Occlusal Equilibration:
A. As part of a full surgical case No Charge No Charge
B. As a seperate procedure,
not to exceed 3 visits
$125.00 $210.00
Perio Maintenence Procedure, includes exam
(following active therapy)
$105.00 $160.00
Full Surgical Case:
Includes 4 Quadrants of osseous surgery,
occlusal adjustment, 4 quadrants of
periodontal scaling (not to exceed)
$3325.00 $4395.00
Partial Cases: Are based upon above fee schedule.
**Specialist's Initial Consultation fee will be applied towards Diagnosis/Records/Charting unless perfomed as a separate visit

horizontal rule

 

PROSTHODONTIST
Participating Prosthodontists will provide a 30% discount off their usual rates for all NDPA members

 

 

PEDODONTIST
All Pedodontists will provide a 20% discount off their usual rates for all NDPA members

 

 

TMJ SPECIALIST
(Temporomandibular Joint Syndrome)
Providers who treat TMJ will provide a 20% discount off their usual rates for all NDPA members.

 

bulletPlease Note: Rates are Subject to Periodic Change
Without Prior Notification