Procedure | ADA Code | Fee* | With Cigna** | You Save | % |
---|---|---|---|---|---|
Two periodic Exams | ADA Code: D0120 | Usual Fee*: $147.00 | With Cigna**: $48.00 | You Save: $99.00 | Saving Percentage: 67% |
Two routine cleanings (adult) | ADA Code: D1110 | Usual Fee*: $250.00 | With CignaPlus**: $107.50 | You Save: $142.50 | Saving Percentage: 57% |
Two routine cleanings (child) | ADA Code: D1120 | Usual Fee*: $182.00 | With CignaPlus**: $75.00 | You Save: $107.00 | Saving Percentage: 59% |
Two fluoride treatments (child) | ADA Code: D1203 | Usual Fee*: $112.00 | With CignaPlus**: $34.50 | You Save: $77.50 | Saving Percentage: 69% |
Two bitewing x-rays | ADA Code: D0274 | Usual Fee*: $83.50 | With CignaPlus**: $30.75 | You Save: $52.75 | Saving Percentage: 63% |
One resin composite filling (1-surface anterior,adult or child) | ADA Code: D2330 | Usual Fee*: $222.75 | With CignaPlus**: $69.75 | You Save: $153.00 | Saving Percentage: 69% |
Two quadrants periodontal scaling and root planning | ADA Code: D4341 | Usual Fee*: $579.50 | With CignaPlus**: $229.50 | You Save: $350.00 | Saving Percentage: 60% |
One complete denture | ADA Code: D5110 | Usual Fee*: $1,932.50 | With CignaPlus**: $788.00 | You Save: $1,144.50 | Saving Percentage: 59% |