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-$186
Certain PPO plans may cover 100%
Dental Exam
$79-$89
Periodic Exam (D0120) $79
Comprehensive Exam (D0150) $79
Limited Exam (D0140) $89
Emergency Exam
$0-$89
Certain PPO plans may cover 100%
Dental Cleaning (Prophylaxis)
$73
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)
$46
Fluoride (D1206)
$34
Posterior Composite (White) Fillings
$186-$300
1 surface — $186
2 surface — $203
3 surface — $257
4 surface — $284
5 surface — $300
Certain PPO plans may cover up to 80%
Anterior Composite (White) Fillings
$155-$272
1 surface —$155
2 surface — $186
3 surface — $229
4 surface — $272
Certain PPO plans may cover up to 50-80%
Periodontal Maintenance (D4910)
$123-$213
Certain PPO plans may cover up to 80%
Restorative Dental
Certain insurance plans may cover up to 80%
Porcelain Crown
$1,200-$1,411
$1,200 (crown only)
$1,411 (Including the build up)
Prices with Membership Plan discount
Certain PPO plans cover up to 80%
Scaling & Root Planing
$162-$186
1-3 Teeth (D4342): $162
Quad (D4341): $186
Prices with Membership Plan discount
Root Canals
$719- $919
Anterior (D3310): $719
Bicuspid (D3320): $742
Molar (D3330): $919
Prices with Membership Plan discount
Tooth Extractions
$249
Surgical Extraction (D7210): $249
Prices with Membership Plan discount
Bone Grafts
$371- $800
With Extraction (D7953): $372
Dental Implants (D6010/D6056/D6059)
$4,000-$5,814
D6010: $2,981
D6057: $1,346
D6058: $1,487
Includes 3-D X-ray–certain PPO plans may cover up to 50%
Denture Services
$100 - $2,500
Denture Repair: $100-$348
Denture Reline (D5750 & 5751): $435
Flipper (D5820 & D5821): $558
Complete Upper (D5110): $2,000
Complete Lower (D5120): $2,000
Immediate Upper (D5130): $2,500
Immediate Lower (D5140): $2,500
Upper Partial (D5213): $1,559
Lower Partial (D5214): $1,559
Implant-Supported Dentures
$6,500-$10,500
2 implant overdenture — $6,500
4 implant overdenture — $10,500
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
Sinus Augmentation
$1,575-$2,000
Sinus Bump (D7952): $1,575
Sinus Lift (D7951): $2,000
Cosmetic Dental
Take-Home Whitening (Custom Trays)
$250
Take-Home Whitening (Go Whitening Package)
$150
Porcelain Veneers
$1,500
Additional Services
Orthodontics (D8090)
$4,000-$5,500
Certain PPO plans may cover up to 50%
Nitrous Sedation
$100
Oral Conscious Sedation
$300
Full Arch Occlusal Guard (D9944)
$451
Sleep Apnea Appliance
$5,775
