Please take a moment to review all information that is relevant to you and your visit.

Cost of Common Procedures

Here is a list of the most common procedures performed at Page Dental Arts as in compliance with SB 17-065.

CDT Code Code Nomenclature Description Standard Fee
D0150 COMPREHENSIVE ORAL EVALUATION Complete Oral Exam/New Patient Exam $130
D0120 PERIODIC ORAL EVALUATION Check-up Exam $77
D0140 LIMITED ORAL EVALUATION-PROBLEM FOCUSED Emergency/Single Problem Exam $117
D1110 PROPHYLAXIS-ADULT Basic Cleaning – Adult $123
D1120 PROPHYLAXIS-CHILD Basic Cleaning – Child under 14 $98
D4910 PERIODONTAL MAINTENANCE PROCEDURES Cleaning for Patients w/ History of Gum Disease $189
D0220 INTRAORAL-PERIAPICAL FIRST FILM Single X-ray $44
D0230 INTRAORAL-PERIAPICAL-EACH ADDITIONAL FIL Additional single X-ray $34
D0274 BITEWINGS-FOUR FILMS Cavity Detecting X-rays (Series of 4) $93
D0272 BITEWINGS-TWO FILMS Cavity Detecting X-rays (Series of 2) $64
D2392 RESIN-BASED COMPOSITE-TWO SURFACE, POST. White Filling (Composite Resin), up to 2 Surfaces $355
D2391 RESIN-BASED COMPOSITE-ONE SURFACE, POST. White Filling (Composite Resin), Single Surface $280
D1351 SEALANT-PER TOOTH Application of Sealant, per Tooth $83
D1206 TOPICAL APPLICATION OF FLUORIDE VARNISH Application of Fluoride $53
D4342 PERIODONTAL SCALING AND ROOT PLANNING: 1-3 TEETH/QUAD Deep cleaning to treat gum disease in one area, less than 3 teeth $271


DISCLAIMER: The health care price listed for any given health care service is an estimate. Actual charges for the health care service are dependent on the circumstances, including any complications or exceptional treatment, at the time the service is rendered. Standard Fees listed do not include any discounts or insurance write-offs that you may apply to your situation.

If you are covered by health insurance or a dental plan, you are strongly encouraged to consult with your insurer or plan to determine accurate information about your financial responsibility for a particular health care service provided by a health care provider at this office. If you are not covered by health insurance or a dental plan, you are strongly encouraged to contact our billing office at 303-794-4542 to discuss payment options prior to receiving a health care service from a health care provider at this office since posted health care prices may not reflect the actual amount of your financial responsibility.

Our mission at Page Dental Arts is to help all of our patients have a smile that brings them joy.