|
 |
| |
Please contact
a Regional Vice President of Sales to discuss how we can provide the
benefit design to fit your needs.
|
| |
| |
|
|
In-Network |
 |
Out-of-Network |
 |
 |
|
 |
|
 |
| |
Exam |
|
100% Covered |
|
Fee Schedule |
| |
Adult Prophylaxis |
|
100% Covered |
|
Fee Schedule |
| |
Full Mouth x-ray |
|
100% Covered |
|
Fee Schedule |
| |
Panoramic |
|
100% Covered |
|
Fee Schedule |
| |
Bite-wing x-rays |
|
100% Covered |
|
Fee Schedule |
| |
|
|
|
|
|
| |
Additional Services |
|
Discounted Fee Schedule |
|
Discounted Fee Schedule |
|
|
|
|