Office Fees
Dental Fees & Prices
At Pearl Shine Dental, you are at the center of everything we do. This means being as transparent as possible about who we are, the services we offer, and how our fees are structured. We’ve listed some of our services with fee structures below. Please note that the price of each procedure could vary from these numbers depending on the need—every patient and every case is different.
For those of you with insurance, please note that fees will vary based on your specific PPO plan. We recommend checking your coverage with your benefits administrator or providing us with your insurance information so that we may check on your specific plan. Pearl Shine Dental does not represent your insurance carrier, nor can we promise they will cover all procedures.
Preventative Care
Certain insurance plans may cover up to 100%
Cleaning, Exam, Full Series of X-Rays, Fluoride (D0150)
$0-$170
Certain PPO plans may cover 100%
Dental Exam
$49-$69
Periodic Exam (D0120) $69
Comprehensive Exam (D0150) $69
Limited Exam (D0140) $49
Emergency Exam
$0-$49
Certain PPO plans may cover 100%
Dental Cleaning (Prophylaxis)
$69
Adult and Child Teeth Cleaning (D1110 OR D1120) $69
Dental X-rays
$32-$261
PA (D0220): $41
Addt'l PAs (D0230): $36
1 BWX (D0270): $41
2 BWX (D0272): $62
4 BWX (D0274): $89
Panoramic X-Ray (D0330): $154
CT (D0367): $200
Dental Sealants (D1351)
$42
Fluoride (D1206)
$32
Posterior Composite (White) Fillings
$199-$404
1 surface — $199
2 surface — $253
3 surface — $315
4 surface — $366
5 surface — $404
Certain PPO plans may cover up to 80%
Anterior Composite (White) Fillings
$229-$424
1 surface —$229
2 surface — $278
3 surface — $338
4 surface — $424
Certain PPO plans may cover up to 50-80%
Periodontal Maintenance (D4910)
$184
Certain PPO plans may cover up to 80%
Restorative Dental
Certain insurance plans may cover up to 80%
Porcelain Crown
$956-$1147
$956 (crown only)
$1147 (Including the build up)
Prices with Membership Plan discount
Certain PPO plans cover up to 80%
Scaling & Root Planing
$147-$169
1-3 Teeth (D4342): $147
Quad (D4341): $169
Prices with Membership Plan discount
Root Canals
$652- $833
Anterior (D3310): $652
Bicuspid (D3320): $673
Molar (D3330): $833
Prices with Membership Plan discount
Tooth Extractions
$229
Surgical Extraction (D7210): $229
Prices with Membership Plan discount
Bone Grafts
$337- $800
With Extraction (D7953): $337
Dental Implants (D6010/D6056/D6059)
$3,000-$4,795
D6010: $2,098
D6057: $1163
D6058: $1,534
Includes 3-D X-ray–certain PPO plans may cover up to 50%
Denture Services
$75 - $1,904
Denture Repair: $75-$300
Denture Reline (D5750 & 5751): $394
Flipper (D5820 & D5821): $506
Complete Upper (D5110): $1414
Complete Lower (D5120): $1414
Immediate Upper (D5130): $1414
Immediate Lower (D5140): $1414
Upper Partial (D5213): $1414
Lower Partial (D5214): $1414
Implant-Supported Dentures
$5,500-$9,500
2 implant overdenture — $5,500
4 implant overdenture — $9,500
Includes all costs except sedation and tooth extractions
Implant-Supported Bridge
$20,000 / arch
Includes 6 implants per arch and all costs except tooth extraction
Posterior Composite (White) Fillings
$20-$475
D2391 (1 Surface) $20-$260
D2392 (2 Surfaces) $20-$339
D2393 (3 Surfaces) $20-$407
D2394 (4 Surface) $20-$473
Sinus Augmentation
$800-$2500
Sinus Bump (D7952): $2500
Sinus Lift (D7951): $800
Cosmetic Dental
Take-Home Whitening (Custom Trays)
$250
Take-Home Whitening (Go Whitening Package)
$75
Porcelain Veneers
$1,500
Additional Services
Orthodontics (D8090)
$2,500-$5,200
Certain PPO plans may cover up to 50%
Nitrous Sedation
$95
Oral Conscious Sedation
$150
Full Arch Occlusal Guard (D9944)
$350
Sleep Apnea Appliance
$5,775
