Pediatric Coverage

Ages 12 and under.

100% coverage for:

2 Cleanings

2 Exams

2 Fluoride Treatments

Bitewing X-Rays

*In addition, 10% discount on all other services,
including a panoramic X-ray which is required every 3-5 years.

$361

(Fee without benefits plan: $664)

$479

(Fee without benefits plan: $726)

Adult Plan A

Ages 13 and older.

100% coverage for:

2 Cleanings

2 Exams

2 Flouride Treatments

Bitewing X-Rays

*In addition, 10% discount on all other services,
including a panoramic X-ray which is required every 3-5 years.

Adult Plan B

Ages 13 and older.

100% coverage for:

3 Cleanings

2 Exams

2 Flouride Treatments

Bitewing X-Rays

*In addition, 10% discount on all other services, including a panoramic X-ray which is required every 3-5 years.

$597

(Fee without benefits plan: $870)

$718

(Fee without benefits plan: $1,211)

Adult Plan C

Ages 13 and older.

100% coverage for:

4 Cleanings

2 Exams

2 Flouride Treatments

Bitewing X-Rays

1 Panoramic X-Ray

*In addition, 10% discount on all other services.