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Reduced Fee Schedule
Get some idea of the great savings that NobleDentist offers.
NobleDentist Fee Schedules
- Adelaide Dentist Fee Schedule (SA)
- Brisbane Dentist Fee Schedule (QLD)
- Melbourne Dentist Fee Schedule (VIC)
- Perth Dentist Fee Schedule (WA)
- Sydney Dentist Fee Schedule (NSW)
Adelaide Dentist Fee Schedule (SA)
The 'Maximum Fee' listed below indicates the fee patients could be charged when visiting a dentist in South Australia. The data is based on the Australian Dental Association's annual dental fee survey (plus inflation as the surveys were conducted at least 12 months ago). The 'NobleDentist Fee' is the amount members of NobleDentist pay when visiting a participating Adelaide dentist. Any dental services not included in this fee schedule are reduced by 15% off the usual practice fee that you attend.
| Item Number | Service | Maximum Fee | NobleDentist |
| Diagnostic Services | |||
|---|---|---|---|
| 011 | Oral Exam - Comprehensive | $83 | $41 |
| 012 | Oral Exam - Periodic | $63 | $37 |
| 014 | Consultation | $90 | $42 |
| 022 | X-Ray - Per Film | $48 | $32 |
| 037 | X-Ray - Panoramic (OPG) | $128 | $80 |
| Preventive | |||
| 111 | Plaque/Stain Removal | $81 | $43 |
| 114 | Calculus Removal | $134 | $75 |
| 121/111 | Topical Remineralising & Plaque | $103 | $33 |
| 161 | Fissure Sealant - Per Tooth | $73 | $35 |
| Periodontics | |||
| 222 | Root Planing & Curettage | $230 | $95 |
| 232 | Perio Flap Surgery | $402 | $185 |
| Oral Surgery | |||
| 311 | Removal of a Tooth or Part (s) Thereof | $207 | $100 |
| 323 | Surgical Removal of a Tooth or Part (s) Thereof with Bone Removal | $335 | $180 |
| Endodontics | |||
| 411 | Direct Pulp Capping | $80 | $26 |
| 415 | Chemo-Mechanical Preparation - 1 Canal | $326 | $170 |
| 416 | Chemo-Mechanical Preparation - Additional Canal | $168 | $75 |
| 417 | Pulp Obturation - One Canal | $268 | $170 |
| 418 | Pulp Obturation - Each Additional Canal | $168 | $70 |
| 415,417 | Front Tooth Root Canal (One Canal) (Not Including X-Rays) | $594 | $340 |
| 415,416,417,418 | Premolar Root Canal (Two Canals) (Not Including X-Rays) | $930 | $485 |
| 415,416,416,417,418,418 | Molar Root Canal (Three Canals)(Not Including X-Rays) | $1266 | $630 |
| Restorations | |||
| 511 | Metallic - 1 Surface | $143 | $80 |
| 512 | Metallic - 2 Surfaces | $168 | $98 |
| 513 | Metallic - 3 Surfaces | $223 | $116 |
| 514 | Metallic - 4 Surfaces | $243 | $132 |
| 515 | Metallic - 5 Surfaces | $300 | $153 |
| 521 | White Filling - 1 Surface - Front Tooth | $162 | $90 |
| 522 | White Filling - 2 Surfaces - Front Tooth | $186 | $106 |
| 523 | White Filling - 3 Surfaces - Front Tooth | $217 | $128 |
| 524 | White Filling - 4 Surfaces - Front Tooth | $264 | $149 |
| 525 | White Filling - 5 Surfaces - Front Tooth | $362 | $170 |
| 531 | White Filling - 1 Surface - Back Tooth | $166 | $100 |
| 532 | White Filling - 2 Surfaces - Back Tooth | $200 | $120 |
| 533 | White Filling - 3 Surfaces - Back Tooth | $280 | $140 |
| 534 | White Filling - 4 Surfaces - Back Tooth | $305 | $160 |
| 535 | White Filling - 5 Surfaces - Back Tooth | $352 | $185 |
| 575 | Pin Retention - Per Pin | $46 | $23 |
| 582 | Composite Veneer - Per Tooth | $497 | $200 |
| 583 | Porcelain Veneer - Per Tooth | $1159 | $620 |
| Crowns & Bridges (Lab Fees Included) | |||
| 615 | Full Crown-Veneered | $1588 | $1000 |
| 618 | Full Crown-Metallic | $1646 | $950 |
| 643 | Bridge Pontic-Indirect-Per Pontic (Lab Required) | $1397 | $700 |
| 615,643,615 | 3 Unit Bridge (2 Crowns & 1 Pontic) | $4573 | $2700 |
| 651 | Re-cementing Crown or Veneer | $155 | $80 |
| Prosthodontics | |||
| 711 | Upper Denture | $1561 | $770 |
| 719 | Upper & Lower Denture | $2826 | $1300 |
| 721/733/731 | Partial Denture Acrylic Plate | $1159 | $652 |
| 727/728 | Partial Denture Plate - Cast Metal Framework | $1704 | $915 |
| 743 | Relining - Complete Dentures | $455 | $250 |
| 763 | Repair Base - Complete Dentures | $238 | $90 |
| 768 | Partial Denture – Extracted Tooth Replacement Per Tooth | $238 | $115 |
| 776 | Impression for Denture Repair | $73 | $40 |
| Cosmetic | |||
| 582 | Composite Veneer - Per Tooth | $497 | $200 |
| 583 | Porcelain Veneer - Per Tooth | $1159 | $620 |
| General | |||
| 911 | Palliative Care | $104 | $39 |
| 965 | Occlusal Splint | $610 | $350 |
Brisbane Dentist Fee Schedule (QLD)
The 'Maximum Fee' listed below indicates the fee patients could be charged when visiting a dentist in Queensland. The data is based on the Australian Dental Association's annual dental fee survey (plus inflation as the surveys were conducted at least 12 months ago). The 'NobleDentist Fee' is the amount members of NobleDentist pay when visiting a participating Brisbane dentist. Any dental services not included in this fee schedule are reduced by 15% off the usual practice fee that you attend.
| Item Number | Service | Maximum Fee | NobleDentist |
| Diagnostic Services | |||
|---|---|---|---|
| 011 | Oral Exam - Comprehensive | $85 | $40 |
| 012 | Oral Exam - Periodic | $63 | $32 |
| 014 | Consultation | $82 | $42 |
| 022 | X-Ray - Per Film | $48 | $30 |
| 037 | X-Ray - Panoramic (OPG) | $107 | $78 |
| Preventive | |||
| 111 | Plaque/Stain Removal | $80 | $40 |
| 114 | Calculus Removal | $134 | $72 |
| 121/111 | Topical Mineralising & Plaque | $104 | $27 |
| 161 | Fissure Sealing - Per Tooth | $72 | $38 |
| Periodontics | |||
| 222 | Root Planing & Curettage | $239 | $90 |
| 232 | Perio Flap Surgery | $466 | $180 |
| Oral Surgery | |||
| 311 | Removal of Tooth or Part (s) Thereof | $207 | $100 |
| 322 | Surgical Removal Tooth or Part (s) Thereof Not Requiring Removal of Bone | $300 | $175 |
| Endodontics | |||
| 411 | Direct Pulp Capping | $74 | $27 |
| 415 | Chemo-Mechanical Preparation - 1 Canal | $348 | $180 |
| 416 | Chemo-Mechanical Preparation - Additional Canal | $174 | $75 |
| 417 | Obturation - 1 Canal | $316 | $175 |
| 418 | Obturation - Each Additional Canal | $166 | $75 |
| 415,417 | Front Tooth Root Canal (One Canal) (Not Including X-Rays) | $664 | $355 |
| 415,416,417,418 | Premolar Root Canal (Two Canals) (Not Including X-Rays) | $1004 | $505 |
| 415,416,416,417,418,418 | Molar Root Canal (Three Canals)(Not Including X-Rays) | $1344 | $655 |
| Restorations | |||
| 511 | Metallic - 1 Surface | $145 | $85 |
| 512 | Metallic - 2 Surfaces | $183 | $100 |
| 513 | Metallic - 3 Surfaces | $217 | $120 |
| 514 | Metallic - 4 Surfaces | $254 | $135 |
| 515 | Metallic - 5 Surfaces | $330 | $150 |
| 521 | White Filling - 1 Surface - Front Tooth | $173 | $90 |
| 522 | White Filling - 2 Surfaces - Front Tooth | $197 | $110 |
| 523 | White Filling - 3 Surfaces - Front Tooth | $252 | $125 |
| 524 | White Filling - 4 Surfaces - Front Tooth | $300 | $145 |
| 525 | White Filling - 5 Surfaces - Front Tooth | $362 | $165 |
| 531 | White Filling - 1 Surface - Back Tooth | $176 | $100 |
| 532 | White Filling - 2 Surfaces - Back Tooth | $228 | $125 |
| 533 | White Filling - 3 Surfaces - Back Tooth | $277 | $140 |
| 534 | White Filling - 4 Surfaces - Back Tooth | $328 | $160 |
| 535 | White Filling - 5 Surfaces - Back Tooth | $399 | $180 |
| 575 | Pin Retention - Per Pin | $45 | $23 |
| 582 | Composite Veneer - Per Tooth | $497 | $205 |
| 583 | Porcelain Veneer - Per Tooth | $1439 | $640 |
| Crowns & Bridges (Lab Fees Included) | |||
| 615 | Full Crown-Veneered-Indirect | $1707 | $1050 |
| 618 | Full Crown-Veneered-Indirect-Ceramic & Metal | $1625 | $950 |
| 643 | Bridge Pontic-Indirect-Per Pontic | $1501 | $805 |
| 615,643,615 | 3 Unit Bridge (2 Crowns & 1 Pontic) | $4915 | $2905 |
| 651 | Re-cementing Crown or Veneer | $179 | $80 |
| Prosthodontics | |||
| 711 | Upper Denture | $1578 | $750 |
| 719 | Upper & Lower Denture | $2880 | $1300 |
| 721/733/731 | Partial Denture Acrylic Plate | $1206 | $600 |
| 727/728 | Partial Denture Plate - Cast Metal Framework | $1816 | $950 |
| 743 | Relining - Complete Dentures | $464 | $250 |
| 763 | Repair Base - Complete Dentures | $246 | $90 |
| 768 | Partial Denture – Extracted Tooth Replacement Per Tooth | $248 | $115 |
| 776 | Impression for Denture Repair | $93 | $35 |
| Cosmetic | |||
| 582 | Composite Veneer - Per Tooth | $497 | $205 |
| 583 | Porcelain Veneer - Per Tooth | $1439 | $640 |
| General | |||
| 911 | Palliative Care | $123 | $37 |
| 965 | Occlusal Splint | $717 | $380 |
Melbourne Dentist Fee Schedule (VIC)
The 'Maximum Fee' listed below indicates the fee patients could be charged when visiting a dentist in Victoria. The data is based on the Australian Dental Association's annual dental fee survey (plus inflation as the surveys were conducted at least 12 months ago). The 'NobleDentist Fee' is the amount members of NobleDentist pay when visiting a participating Melbourne dentist. Any dental services not included in this fee schedule are reduced by 15% off the usual practice fee that you attend.
| Item Number | Service | Maximum Fee | NobleDentist |
| Diagnostic Services | |||
|---|---|---|---|
| 011 | Oral Exam - Comprehensive | $93 | $41 |
| 012 | Oral Exam - Periodic | $65 | $37 |
| 014 | Consultation | $98 | $42 |
| 022 | X-Ray - Per Film | $50 | $32 |
| 037 | X-Ray - Panoramic (OPG) | $130 | $75 |
| Preventive | |||
| 111 | Plaque/Stain Removal | $80 | $42 |
| 114 | Calculus Removal | $137 | $75 |
| 121/111 | Topical Remineralising & Plaque | $104 | $33 |
| 161 | Fissure Sealant - Per Tooth | $73 | $39 |
| Periodontics | |||
| 222 | Root Planing & Curettage | $237 | $90 |
| 232 | Perio Flap Surgery | $520 | $200 |
| Oral Surgery | |||
| 311 | Removal of a Tooth or Part (s) Thereof | $210 | $100 |
| 323 | Surgical Removal of a Tooth or Part (s) Thereof with Bone Removal | $399 | $210 |
| Endodontics | |||
| 411 | Direct Pulp Capping | $85 | $28 |
| 415 | Chemo-Mechanical Preparation - 1 Canal | $342 | $180 |
| 416 | Chemo-Mechanical Preparation - Additional Canal | $171 | $80 |
| 417 | Pulp Obturation - One Canal | $329 | $180 |
| 418 | Pulp Obturation - Each Additional Canal | $171 | $80 |
| 415,417 | Front Tooth Root Canal (One Canal) (Not Including X-Rays) | $671 | $360 |
| 415,416,417,418 | Premolar Root Canal (Two Canals) (Not Including X-Rays) | $1013 | $520 |
| 415,416,416,417,418,418 | Molar Root Canal (Three Canals)(Not Including X-Rays) | $1355 | $680 |
| Restorations | |||
| 511 | Metallic - 1 Surface | $153 | $90 |
| 512 | Metallic - 2 Surfaces | $181 | $105 |
| 513 | Metallic - 3 Surfaces | $217 | $125 |
| 514 | Metallic - 4 Surfaces | $265 | $140 |
| 515 | Metallic - 5 Surfaces | $321 | $160 |
| 521 | White Filling - 1 Surface - Front Tooth | $175 | $100 |
| 522 | White Filling - 2 Surfaces - Front Tooth | $204 | $115 |
| 523 | White Filling - 3 Surfaces - Front Tooth | $254 | $135 |
| 524 | White Filling - 4 Surfaces - Front Tooth | $303 | $155 |
| 525 | White Filling - 5 Surfaces - Front Tooth | $370 | $175 |
| 531 | White Filling - 1 Surface - Back Tooth | $177 | $105 |
| 532 | White Filling - 2 Surfaces - Back Tooth | $218 | $125 |
| 533 | White Filling - 3 Surfaces - Back Tooth | $274 | $145 |
| 534 | White Filling - 4 Surfaces - Back Tooth | $335 | $165 |
| 535 | White Filling - 5 Surfaces - Back Tooth | $399 | $185 |
| 575 | Pin Retention - Per Pin | $45 | $26 |
| 582 | Composite Veneer - Per Tooth | $502 | $210 |
| 583 | Porcelain Veneer - Per Tooth | $1408 | $640 |
| Crowns & Bridges (Lab Fees Included) | |||
| 615 | Full Crown-Veneered | $1684 | $1050 |
| 618 | Full Crown-Metallic | $1646 | $1000 |
| 643 | Bridge Pontic-Indirect-Per Pontic (Lab Required) | $1547 | $850 |
| 615,643,615 | 3 Unit Bridge (2 Crowns & 1 Pontic) | $4915 | $2950 |
| 651 | Re-cementing Crown or Veneer | $181 | $80 |
| Prosthodontics | |||
| 711 | Upper Denture | $1552 | $775 |
| 719 | Upper & Lower Denture | $2846 | $1300 |
| 721/733/731 | Partial Denture Acrylic Plate | $1159 | $635 |
| 727/728 | Partial Denture Plate - Cast Metal Framework | $1822 | $1000 |
| 743 | Relining - Complete Dentures | $455 | $265 |
| 763 | Repair Base - Complete Dentures | $248 | $90 |
| 768 | Partial Denture – Extracted Tooth Replacement Per Tooth | $248 | $115 |
| 776 | Impression for Denture Repair | $95 | $37 |
| Cosmetic | |||
| 582 | Composite Veneer - Per Tooth | $502 | $210 |
| 583 | Porcelain Veneer - Per Tooth | $1408 | $640 |
| General | |||
| 911 | Palliative Care | $122 | $37 |
| 965 | Occlusal Splint | $719 | $395 |
Perth Dentist Fee Schedule (WA)
The 'Maximum Fee' listed below indicates the fee patients could be charged when visiting a dentist in Western Australia. The data is based on the Australian Dental Association's annual dental fee survey (plus inflation as the surveys were conducted at least 12 months ago). The 'NobleDentist Fee' is the amount members of NobleDentist pay when visiting a participating Perth dentist. Any dental services not included in this fee schedule are reduced by 15% off the usual practice fee that you attend.
| Item Number | Service | Maximum Fee | NobleDentist |
| Diagnostic Services | |||
|---|---|---|---|
| 011 | Oral Exam - Comprehensive | $83 | $41 |
| 012 | Oral Exam - Periodic | $65 | $37 |
| 014 | Consultation | $102 | $42 |
| 022 | X-Ray - Per Film | $49 | $30 |
| 037 | X-Ray - Panoramic (OPG) | $124 | $70 |
| Preventive | |||
| 111 | Plaque/Stain Removal | $78 | $42 |
| 114 | Calculus Removal | $136 | $73 |
| 121/111 | Topical Remineralising & Plaque | $104 | $32 |
| 161 | Fissure Sealant - Per Tooth | $73 | $39 |
| Periodontics | |||
| 222 | Root Planing & Curettage | $207 | $90 |
| 232 | Perio Flap Surgery | $497 | $180 |
| Oral Surgery | |||
| 311 | Removal of a Tooth or Part (s) Thereof | $213 | $105 |
| 323 | Surgical Removal of a Tooth or Part (s) Thereof with Bone Removal | $403 | $200 |
| Endodontics | |||
| 411 | Direct Pulp Capping | $77 | $30 |
| 415 | Chemo-Mechanical Preparation - 1 Canal | $333 | $170 |
| 416 | Chemo-Mechanical Preparation - Additional Canal | $171 | $72 |
| 417 | Pulp Obturation - One Canal | $327 | $165 |
| 418 | Pulp Obturation - Each Additional Canal | $171 | $77 |
| 415,417 | Front Tooth Root Canal (One Canal) (Not Including X-Rays) | $660 | $335 |
| 415,416,417,418 | Premolar Root Canal (Two Canals) (Not Including X-Rays) | $1002 | $489 |
| 415,416,416,417,418,418 | Molar Root Canal (Three Canals)(Not Including X-Rays) | $1344 | $638 |
| Restorations | |||
| 511 | Metallic - 1 Surface | $150 | $90 |
| 512 | Metallic - 2 Surfaces | $185 | $100 |
| 513 | Metallic - 3 Surfaces | $222 | $127 |
| 514 | Metallic - 4 Surfaces | $253 | $140 |
| 515 | Metallic - 5 Surfaces | $326 | $156 |
| 521 | White Filling - 1 Surface - Front Tooth | $171 | $94 |
| 522 | White Filling - 2 Surfaces - Front Tooth | $197 | $112 |
| 523 | White Filling - 3 Surfaces - Front Tooth | $243 | $132 |
| 524 | White Filling - 4 Surfaces - Front Tooth | $288 | $149 |
| 525 | White Filling - 5 Surfaces - Front Tooth | $365 | $172 |
| 531 | White Filling - 1 Surface - Back Tooth | $176 | $102 |
| 532 | White Filling - 2 Surfaces - Back Tooth | $228 | $125 |
| 533 | White Filling - 3 Surfaces - Back Tooth | $269 | $140 |
| 534 | White Filling - 4 Surfaces - Back Tooth | $331 | $165 |
| 535 | White Filling - 5 Surfaces - Back Tooth | $346 | $190 |
| 575 | Pin Retention - Per Pin | $42 | $25 |
| 582 | Composite Veneer - Per Tooth | $492 | $200 |
| 583 | Porcelain Veneer - Per Tooth | $1399 | $640 |
| Crowns & Bridges (Lab Fees Included) | |||
| 615 | Full Crown-Veneered | $1656 | $1000 |
| 618 | Full Crown-Metallic | $1578 | $950 |
| 643 | Bridge Pontic-Indirect-Per Pontic (Lab Required) | $1516 | $810 |
| 615,643,615 | 3 Unit Bridge (2 Crowns & 1 Pontic) | $4573 | $2810 |
| 651 | Re-cementing Crown or Veneer | $181 | $75 |
| Prosthodontics | |||
| 711 | Upper Denture | $1604 | $770 |
| 719 | Upper & Lower Denture | $2885 | $1300 |
| 721/733/731 | Partial Denture Acrylic Plate | $1159 | $705 |
| 727/728 | Partial Denture Plate - Cast Metal Framework | $1850 | $950 |
| 743 | Relining - Complete Dentures | $461 | $280 |
| 763 | Repair Base - Complete Dentures | $246 | $85 |
| 768 | Partial Denture – Extracted Tooth Replacement Per Tooth | $252 | $120 |
| 776 | Impression for Denture Repair | $86 | $37 |
| Cosmetic | |||
| 582 | Composite Veneer - Per Tooth | $492 | $200 |
| 583 | Porcelain Veneer - Per Tooth | $1399 | $640 |
| General | |||
| 911 | Palliative Care | $114 | $37 |
| 965 | Occlusal Splint | $711 | $380 |
Sydney Dentist Fee Schedule (NSW)
The 'Maximum Fee' listed below indicates the fee patients could be charged when visiting a dentist in New South Wales. The data is based on the Australian Dental Association's annual dental fee survey (plus inflation as the surveys were conducted at least 12 months ago). The 'NobleDentist Fee' is the amount members of NobleDentist pay when visiting a participating Sydney dentist. Any dental services not included in this fee schedule are reduced by 15% off the usual practice fee that you attend.
| Item Number | Service | Maximum Fee | NobleDentist |
| Diagnostic Services | |||
|---|---|---|---|
| 011 | Oral Exam - Comprehensive | $97 | $42 |
| 012 | Oral Exam - Periodic | $66 | $37 |
| 014 | Consultation | $101 | $42 |
| 022 | X-Ray - Per Film | $50 | $32 |
| 037 | X-Ray - Panoramic (OPG) | $124 | $79 |
| Preventive | |||
| 111 | Plaque/Stain Removal | $82 | $42 |
| 114 | Calculus Removal | $135 | $75 |
| 121/111 | Topical Remineralising & Plaque | $104 | $32 |
| 161 | Fissure Sealant - Per Tooth | $74 | $39 |
| Periodontics | |||
| 222 | Root Planing & Curettage | $234 | $90 |
| 232 | Perio Flap Surgery | $501 | $180 |
| Oral Surgery | |||
| 311 | Removal of a Tooth or Part (s) Thereof | $212 | $100 |
| 323 | Surgical Removal of a Tooth or Fragment with Bone Removal | $399 | $210 |
| Endodontics | |||
| 411 | Direct Pulp Capping | $85 | $28 |
| 415 | Chemo-Mechanical Preparation - 1 Canal | $347 | $180 |
| 416 | Chemo-Mechanical Preparation - Additional Canal | $176 | $75 |
| 417 | Pulp Obturation - 1 Canal | $326 | $170 |
| 418 | Pulp Obturation - Each Additional Canal | $166 | $80 |
| 415,417 | Front Tooth Root Canal (One Canal) (Not Including X-Rays) | $673 | $350 |
| 415,416,417,418 | Premolar Root Canal (Two Canals) (Not Including X-Rays) | $1015 | $505 |
| 415,416,416, 417,418,418 | Molar Root Canal (Three Canals)(Not Including X-Rays) | $1357 | $660 |
| Restorations | |||
| 511 | Metallic - 1 Surface | $150 | $85 |
| 512 | Metallic - 2 Surfaces | $184 | $95 |
| 513 | Metallic - 3 Surfaces | $222 | $130 |
| 514 | Metallic - 4 Surfaces | $268 | $150 |
| 515 | Metallic - 5 Surfaces | $311 | $165 |
| 521 | White Filling - 1 Surface - Front Tooth | $171 | $100 |
| 522 | White Filling - 2 Surfaces - Front Tooth | $203 | $115 |
| 523 | White Filling - 3 Surfaces - Front Tooth | $258 | $130 |
| 524 | White Filling - 4 Surfaces - Front Tooth | $300 | $155 |
| 525 | White Filling - 5 Surfaces - Front Tooth | $362 | $175 |
| 531 | White Filling - 1 Surface - Back Tooth | $176 | $100 |
| 532 | White Filling - 2 Surfaces - Back Tooth | $229 | $125 |
| 533 | White Filling - 3 Surfaces - Back Tooth | $280 | $140 |
| 534 | White Filling - 4 Surfaces - Back Tooth | $335 | $165 |
| 535 | White Filling - 5 Surfaces - Back Tooth | $399 | $185 |
| 575 | Pin Retention - Per Pin | $44 | $24 |
| 582 | Composite Veneer - Per Tooth | $486 | $210 |
| 583 | Porcelain Veneer - Per Tooth | $1444 | $640 |
| Crowns & Bridges (Lab Fees Included) | |||
| 615 | Full Crown-Veneered-Indirect-Ceramic & Metal | $1663 | $1050 |
| 618 | Full Crown-Metallic-Indirect | $1651 | $1000 |
| 643 | Bridge Pontic-Indirect-Per Pontic | $1547 | $850 |
| 615,643,615 | Bridge Pontic-Indirect-Per Pontic (Lab Required) | $4873 | $2950 |
| 651 | Re-cementing Crown or Veneer | $181 | $80 |
| Prosthodontics | |||
| 711 | Upper Denture | $1630 | $765 |
| 719 | Upper & Lower Denture | $2691 | $1300 |
| 721/733/731 | Partial Denture Acrylic Plate | $1190 | $650 |
| 727/728 | Partial Denture Plate - Cast Metal Framework | $1794 | $1000 |
| 743 | Relining - Complete Dentures | $456 | $270 |
| 763 | Repair Base - Complete Dentures | $255 | $90 |
| 768 | Partial Denture – Extracted Tooth Replacement Per Tooth | $249 | $115 |
| 776 | Impression for Denture Repair | $99 | $37 |
| Cosmetic | |||
| 582 | Composite Veneer - Per Tooth | $487 | $210 |
| 583 | Porcelain Veneer - Per Tooth | $1444 | $640 |
| General | |||
| 911 | Palliative Care | $124 | $36 |
| 965 | Occlusal Splint | $722 | $395 |