Savings Examples

Procedure Average Cost* Average Cost with Aetna Dental Access* Member Savings
Periodic Oral Exam $70 $35 $35
Comprehensive Oral Exam $108 $50 $58
X-Ray, Intraoral–Complete Series Including Bitewing $163 $87 $76
X-Ray, Bitewings– Four Films $79 $41 $38
X-Ray Panoramic Film $139 $78 $61
Cleaning (Prophylaxis)–Adult $124 $67 $57
Cleaning (Prophylaxis)–Child $91 $51 $40
Sealant Per Tooth $72 $37 $35
Filling– 1 Surface Resin (White) Filling, Front (Anterior) Tooth $200 $101 $99
Crown– Porcelain Fused to High Noble Metal (i.e. gold) $1,278 $825 $453
Restorative Crown – Porcelain Fused to Noble Metal $1,236 $790 $446
Root Canal Front Tooth (Anterior) Excluding Final Restoration $860 $531 $329
Root Canal Premolar Tooth (Bicuspid), Excluding Final Restoration $973 $632 $341
Root Canal Molar, Excluding Final Restoration $1,189 $851 $338
Scaling/Root Planing Four or More Contiguous Teeth $272 $162 $110
Periodontal Maintenance For Patients Who Have Been Previously Treated For Periodontal Disease $166 $90 $76
Complete Upper Denture (Maxillary) $1,528 $1,003 $525
Extraction of Erupted Tooth or Exposed Root – Includes Local Anesthesia and Suturing If Needed $219 $99 $120
Comprehensive Orthodontic Treatment Child $5,991 $3,549 $2,442

*Actual costs and savings may vary by provider, service and geographic location. We use the average of negotiated fees from participating providers to determine the average costs, as shown on the chart. The select regional average cost represents the average fees for the procedures listed above in Los Angeles, Orlando, Chicago and New York City, as displayed in the cost of care tool as of June 2018.

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