Dental Procedure |
Average Fee |
You Pay |
You Save |
| Oral Exam –Comprehensive | $195 | $52 | 73% |
| Periodic Oral Exam | $125 | $31 | 75% |
| X-rays –Full Mouth | $215 | $90 | 58% |
| Prophy –Simple Cleaning | $135 | $65 | 52% |
| Sealant | $87 | $39 | 55% |
| Silver Filling –3 surface | $235 | $142 | 40% |
| White Ceramic Filling –3 surface | $345 | $159 | 54% |
| Porcelain Crown | $1,525 | $782 | 49% |
| Root Canal –Molar | $1,405 | $793 | 44% |
| Periodontal(Gum) Surgery | $1,415 | $861 | 39% |
| PerioScaling –Deep Cleaning | $225 | $166 | 26% |
| Upper Denture | $1,575 | $970 | 38% |
| Implant –singletooth | $2,775 | $1,255 | 55% |
| Extraction –simple | $265 | $106 | 60% |
Drug |
You Pay |
Retail Price |
| Alprazolam tab 2mg (90 tabs) | $21.51 | $201.49 |
| Amlodipine tab 10mg (90 tabs) | $14.67 | $137.99 |
| Buproprion tab 300mg XL (30 tabs) | $31.46 | $193.38 |
| Catapres 0.1mg (90 tabs) | $171.23 | $232.99 |
| Gabapentin tab 800mg (90 tabs) | $56.40 | $201.89 |
| Humira kit 40mg/0.8 (2x: 8 day) | $2,089.81 | $2,334.99 |
| Lansoprazole cap 30mg DR (60 caps) | $112.97 | $346.99 |
| Lipitor 40mg (60 tabs) | $400.05 | $493.99 |
| Losartan tab 50mg (90 tabs) | $31.20 | $203.65 |
| Oxycodone tab 30mg (180 tabs) | $123.30 | $264.19 |
| Risperidone tab 3mg (90 tabs) | $73.81 | $715.99 |
| Simvastatin tab 20mg (90 tabs) | $16.30 | $447.85 |
| Symlinpen 60 inj. 1000mcg (2x) | $208.71 | $442.99 |
| Xanax .5mg (90 tabs) | $205.63 | $292.99 |
Description |
Regular Cost |
Plan Cost |
Sample Savings |
| Eye Exam | $134 | $80 | $54 |
| Frame | $200 | $150 | $50 |
| Single Vision Lenses | $83 | $45 | $38 |
| Transition® Lenses | $96 | $77 | $19 |
| Anti-Reflective Coating | $76 | $45 | $31 |
