(408) 784-3006
(408) 784-3006

Compare Membership Plans

PROCEDURE NON-MEMBERSHIP
PLAN COSTS
ADULT/CHILDREN
MEMBERSHIP
PLAN COSTS
SHIRLEY SENIOR
MEMBERSHIP
PLAN COSTS
EXAM, X-RAYS, & CLEANING (2xYEAR) $200 FREE FREE
EMERGENCY AND LIMITED EXAM $35 FREE FREE
WISDOM TEETH CONSULT FREE FREE FREE
BRACES CONSULT FREE FREE FREE
PALLIATIVE TREATMENT $80 $64 $56
PANO X-RAY $80 $64 $56
CONE BEAM CT SCAN $200 $160 $140
1 SURFACE COMPOSITE FILLING $125 $100 $87.50
2 SURFACE COMPOSITE FILLING $155 $124 $108.50
3 SURFACE COMPOSITE FILLING $185 $148 $129.50
4+ SURFACE COMPOSITE FILLING $215 $172 $150.50
CERAMIC CROWN $900 $720 $630
BRIDGE ABUTMENT CROWN $900 $720 $630
BRIDGE PONTIC CROWN $900 $720 $630
CORE BUILD UP $125 $100 $87.50
POST BUILD UP $175 $140 $122.50
CAST POST BUILD UP $275 $220 $192.50
CROWN RECEMENTATION $80 $64 $56
DEEP CLEANING PER QUAD (1-3 TEETH) $80 $64 $56
DEEP CLEANING PER QUAD (4-8 TEETH) $125 $100 $87
ANTERIOR ROOT CANAL THERAPY $450 $360 $315
PREMOLAR ROOT CANAL THERAPY $550 $440 $385
MOLAR ROOT CANAL THERAPY $650 $520 $455
SEALANT $45 $36 N/A
FIXED SPACE MAINTAINER $265 $212 N/A
PRIMARY TEETH EXTRACTION $50 $40 N/A
ROUTINE EXTRACTION $125 $100 $87
SURGICAL EXTRACTION $175 $140 $122
SOFT TISSUE EXTRACTION $225 $180 $157.50
PARTIAL BONY EXTRACTION $325 $260 $227.50
COMPLETE BONY EXTRACTION $425 $340 $297.50
BONE GRAFT $400 $320 $280
IMPLANT $1,500 $1,500 $1,050
IMPLANT CROWN $1,500 $1,500 $1,050
IMPLANT ABUTMENT $300 $300 $210
COMPLETE DENTURE $1,350 $1,350 $945
COMPLETE IMMEDIATE DENTURE $1,450 $1,450 $1,015
METAL BASE PARTIAL DENTURE $1,450 $1,450 $1,015

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