| # | Services | Cost (USD) |
|---|---|---|
|
1
|
Examiniation
|
5
|
|
2
|
Class I Restoration
|
50
|
|
3
|
Class II Restoration
|
60
|
|
4
|
Class III Restoration
|
66
|
|
5
|
Class IV Restoration (Buildup)
|
80
|
|
6
|
Root canal (front tooth)
|
85
|
|
7
|
Bicuspid root canal (premolar)
|
120
|
|
8
|
Molar root canal
|
170
|
|
9
|
Simple tooth extraction
|
25
|
|
10
|
Surgical tooth extraction
|
45
|
|
11
|
Wisdom tooth extraction (per tooth)
|
85
|
|
12
|
Soft Tissue Surgery
|
66
|
|
13
|
Hard Tissue Surgery (Semi-impacted)
|
135
|
|
14
|
Hard Tissue Surgery (Impacted)
|
170
|
|
15
|
Removal of Remaining Root
|
50
|
|
16
|
Gingivectomy or Gingivoplasty (Four Adjacent Teeth or Quadrant Spaces)
|
90
|
|
17
|
Gingivectomy or Gingivoplasty (One to Three Adjacent Teeth in Each Quadrant)
|
60
|
|
18
|
Crown Lengthening for Restoration (Soft Tissue Only, per Tooth)
|
45
|
|
19
|
Clinical Crown Lengthening (Hard Tissue, per Tooth)
|
85
|
|
20
|
Gingival Flap (One to Three Adjacent Teeth)
|
85
|
|
21
|
Gingival Flap (Four or More Adjacent Teeth)
|
110
|
|
22
|
Guided Bone Regeneration (GBR) per Unit
|
75
|
|
23
|
Guided Tissue Regeneration (GTR) per Unit (For Teeth)
|
92
|
|
24
|
Soft Tissue Graft
|
100
|
|
25
|
Mesial or Distal Wedge (Single Tooth)
|
85
|
|
26
|
Free Gingival Graft (FGG) - Single Unit
|
200
|
|
27
|
FGG - Additional Units
|
66
|
|
28
|
Full Oral Scaling (Specialized)
|
80
|
|
29
|
Explant Treatment (per Unit)
|
100
|
|
30
|
Peri-implantitis Treatment (No Bone Graft, Cleaning Only)
|
100
|
|
31
|
Extraction of Primary Anterior Tooth
|
17
|
|
32
|
Extraction of Primary Posterior Tooth
|
25
|
|
33
|
Pulpotomy (Primary Tooth)
|
50
|
|
34
|
Pulpectomy (Primary Tooth)
|
66
|
|
35
|
Scaling and Polishing (Both Arches)
|
35
|
|
36
|
Fluoride Therapy (Both Arches)
|
50
|
|
37
|
Stripping per Tooth
|
17
|
|
38
|
Band and Loop Space Maintainer
|
50
|
|
39
|
Stainless Steel Crown
|
66
|
|
40
|
Sedation for Children up to 12 Years (by Anesthesiologist)
|
132
|
|
41
|
General Anesthesia
|
170
|
|
42
|
Fixed Prosthesis (PFM) per Unit
|
170
|
|
43
|
Fixed Prosthesis (PFM Pontic) per Unit
|
120
|
|
44
|
Post and Core per Unit
|
66
|
|
45
|
Full Ceramic Crown
|
200
|
|
46
|
Veneer (Laminate)
|
235
|
|
47
|
Removal of Fused Old Crowns
|
35
|
|
48
|
Cementing Old Crowns per Unit
|
17
|
|
49
|
Removal of Post, Core, or Pin
|
45
|
|
50
|
Overdenture on Ball Attachments per Arch
|
2500
|
|
51
|
Overdenture on Bar Attachments per Arch
|
3350
|
|
52
|
Full Denture per Arch
|
670
|
|
53
|
Korean Implant Unit (One Q)
|
250
|
|
54
|
Korean Implant Unit (SQ)
|
300
|
|
55
|
Korean Implant Unit (Dio)
|
370
|
|
56
|
Swiss Neodent Implant Unit
|
590
|
|
57
|
Swiss Straumann Implant Unit (Standard)
|
670
|
|
58
|
Swiss Straumann Implant Unit (Roxolid)
|
800
|
|
59
|
Block Bone Graft
|
340
|
|
60
|
Bone Graft per Implant Unit
|
170
|
|
61
|
Simultaneous GBR with Implant Placement
|
200
|
|
62
|
Explant of Old Implant Unit
|
170
|
|
63
|
Sinus Lift (Closed)
|
170
|
|
64
|
Sinus Lift (Open)
|
250
|
|
65
|
Frenectomy with Laser
|
120
|
|
66
|
Oral Lesion Surgery for Pathology
|
250
|
