Cost of Common Procedures
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. (updated Feb 2024)
| CDT Code | Code Nomenclature | Description | Standard Fee |
|---|---|---|---|
| D0150 | COMPREHENSIVE ORAL EVALUATION | Complete Oral Exam/New Patient Exam | $140 |
| D0120 | PERIODIC ORAL EVALUATION | Check-up Exam | $81 |
| D0140 | LIMITED ORAL EVALUATION-PROBLEM FOCUSED | Emergency/Single Problem Exam | $123 |
| D1110 | PROPHYLAXIS-ADULT | Basic Cleaning – Adult | $139 |
| D1120 | PROPHYLAXIS-CHILD | Basic Cleaning – Child under 14 | $103 |
| D4910 | PERIODONTAL MAINTENANCE PROCEDURES | Cleaning for Patients w/ History of Gum Disease | $205 |
| D0220 | INTRAORAL-PERIAPICAL FIRST FILM | Single X-ray | $46 |
| D0230 | INTRAORAL-PERIAPICAL-EACH ADDITIONAL FIL | Additional single X-ray | $39 |
| D0274 | BITEWINGS-FOUR FILMS | Cavity Detecting X-rays (Series of 4) | $98 |
| D0272 | BITEWINGS-TWO FILMS | Cavity Detecting X-rays (Series of 2) | $67 |
| D2392 | RESIN-BASED COMPOSITE-TWO SURFACE, POST. | White Filling (Composite Resin), up to 2 Surfaces | $373 |
| D2391 | RESIN-BASED COMPOSITE-ONE SURFACE, POST. | White Filling (Composite Resin), Single Surface | $294 |
| D1351 | SEALANT-PER TOOTH | Application of Sealant, per Tooth | $87 |
| D1206 | TOPICAL APPLICATION OF FLUORIDE VARNISH | Application of Fluoride | $61 |
| D4342 | PERIODONTAL SCALING AND ROOT PLANNING: 1-3 TEETH/QUAD | Deep cleaning to treat gum disease in one area, less than 3 teeth | $289 |
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.