Prosthodontics - Removable
| D5110 | Complete
Upper Denture (Including Six Months Post Care) |
$400.00 |
| D5120 | Complete
Lower Denture (Including Six Months Post Care) |
$400.00 |
| D5130 | Immediate Upper | $420.00 |
| D5140 | Immediate Lower | $420.00 |
| D5211 | Upper Partial Denture - Resin Base | $250.00 |
| D5212 | Lower Partial Denture - Resin Base | $250.00 |
| D5213 | Upper Partial - Predominantly Cast Base |
$400.00 |
| D5214 | Lower Partial - Predominantly Cast Base |
$400.00 |
| D5410 | Adjust Complete Denture | $15.00 |
| D5510 | Repair Broken Complete Denture Base | $40.00 |
| D5610 | Repair Resin Denture Base | $35.00 |
| D5630 | Repair or Replace Broken Clasp | $45.00 |
| D5640 | Replace Broken Teeth - Per Tooth | $30.00 |
| D5650 | Add Tooth to Existing Partial Denture | $45.00 |
| D5660 | Add Clasp to Existing Partial Denture | $65.00 |
| D5730 | Reline Complete Upper (Chairside) | $75.00 |
| D5731 | Reline Complete Lower (Chairside) | $75.00 |
| D5740 | Reline Upper Partial (Chairside) | $75.00 |
| D5741 | Reline Lower Partial (Chairside) | $75.00 |
| D5810 | Temporary Complete Denture Upper | $200.00 |
| D5811 | Temporary Complete Denture Lower | $200.00 |
| D5820 | Temporary Partial - Stay Plate Upper | $180.00 |
| D5821 | Temporary Partial - Stay Plate Lower | $180.00 |