Common Dental Procedures – Cost + Insurance Coverage

Cathy Jakicic
January 30th, 2020 January 30th, 2020 |
Read time: 11 minutes

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Cover your mouth – From routine cleanings to root canals, dental coverage can help keep your teeth and gums healthy.

Uh oh, did you chip a tooth? Or maybe you require a filling or tooth extraction? Even with the best oral hygiene habits, chances are you’ll need more than just a dental cleaning at some point in your life.

So, how much do more complicated procedures like root canals, fillings, and crowns typically cost; and will dental insurance cover them? Well, the answer depends.

Though you may find different coverage rates or additional levels as you shop around for dental plans, a typical dental plan provides 100/80/50 coverage.[1] That means:

  • Preventive care is covered 100%
  • Basic procedures are covered 80%
  • Major procedures are covered 50%

Common Dental Procedures Costs + Coverage

We’ll go into more detail about these common dental procedures later in this blog post, for now, here’s a quick look at average costs and coverage levels to give you a general idea.

Remember, an insurance company may classify a procedure differently than is shown here, and circumstances unique to each person that can’t be accounted for here will also factor into actual costs.

Procedure Cost without insurance (per tooth) Level of coverage[2]
Routine tooth extraction[3] $112-$294+ Basic – 80%
Wisdom tooth extraction (erupted)[4] $447-$1,172+ Basic – 80%
Dental surgery (surgical tooth extraction including bone)[5] $183-$479+ Basic – 80%
Chipped tooth repair[6] $176-$462+ Basic – 80%
White Filling (one surface)[7] $119-$311+ Basic – 80%
White Crown[8] $792-$2,079+ Major – 50%
Anterior Root Canal[9] $575 – $1,508+ Major – 50%

 

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Tooth Extractions Cost + Coverage

Sometimes a tooth extraction is necessary because of disease, decay, accidental damage or crowding.[10] Wisdom teeth, for example, are sometimes removed if they are crowding nearby teeth, or when they are impacted, meaning they haven’t emerged from the gums.[11]

Your cost to have a tooth pulled without insurance can depend on a number of factors, including:[12]

  • What type of tooth it is and where it’s located
  • Whether or not the tooth is impacted
  • What kind of anesthesia is used
  • Whether or not it’s an emergency extraction
  • Where you live[13]

So, how much does it cost to have a tooth pulled without insurance?

A simple tooth extraction of a fully erupted tooth usually costs between $112 and $294+,[14] while a more complicated procedure involving an impacted tooth costs from $214 to $561+.[15]

A simple wisdom tooth extraction of a fully erupted tooth (with general anesthesia) costs $447 to $1,172+ per tooth.[16] That means the cost of removing all four fully erupted wisdom teeth can run from $1,788 to $4,688 or more.

Extraction of an impacted wisdom tooth costs $526 – $1,380.[17] That means that four impacted wisdom teeth could cost from $2,104 -$5,520.

Does Dental Insurance Cover Extractions?

Simple and surgical extractions are usually classified as a basic procedure and could be covered at 80%.[18] If the extraction is considered “medically necessary,” your medical insurance may pick up part of the bill.[19]

Chipped Tooth Repair Cost + Coverage

Though some people may be at an increased risk for chipped teeth, almost anyone could experience one as a result of biting down on hard food, grinding their teeth at night, playing sports without proper protective gear, or sustaining a mouth injury in a fall or accident.[20]

If you accidentally chip or break a tooth it’s important to see your dentist as soon as possible to avoid further damage or infection.[21]

How much does it cost to fix a chipped tooth without insurance? Depending on the damage, a chipped or broken tooth may be repaired with dental bonding; a veneer, which covers the front of the tooth; or an onlay (sometimes called a partial crown) which covers just a portion of a back tooth.[22]

Tooth planing or smoothing, or a tooth reattachment (cementing the chip back on) may also be options depending on the severity of the chip and if you still have the broken piece.[23]

Average per-tooth cost for these types of procedures are as follows:

  • Bonding: $100 – $1,000[24]
  • Porcelain Veneer: $771 – $2,023[25]
  • Prefabricated Metallic Onlay: $684 to $1,796+[26]
  • Tooth planing or smoothing: $100[27]
  • Tooth reattachment: could be just a bit more than the cost of the exam ($50 to $350)[28]

Does Dental Insurance Cover Chipped or Broken Tooth Repair?

Typically yes – if the procedure is done for structural reasons or the health of the tooth, a repair procedure will generally be covered at 80%.[29]

If done for cosmetic reasons, such as to fill a tooth gap or improve the shape or color of the tooth, the repair procedure will likely not be covered by insurance. Veneers, for instance, are often considered cosmetic, so may not be covered by insurance.[30]

Tooth Filling Cost + Coverage

Cavities can be caused by poor dental hygiene, a sugary diet, dry mouth, an accumulation of plaque (bacteria) or some medical conditions, such as diabetes or Celiac’s disease.[31]

According to 2016 numbers from the Centers for Disease Control and Prevention (CDC), More than 90% of U.S. adults have had a cavity, and 1 in 4 has untreated cavities.[32]

How much would it cost to treat these cavities without insurance? The price of a filling can depend on a number of factors, including what type of filling material is used. The dentist usually will choose the type of filling based on the size of the cavity and the location of the tooth. Amalgam is silver-colored. Resin and porcelain are usually tooth-colored.

The average prices for three common types of fillings are:[33]

  • Amalgam: $132
  • Resin composite (white): $155
  • Gold crown (back tooth): $1,123

Does Dental Insurance Cover a Filling?

Most dental insurance plans will cover most of the cost of fillings and related expenses, such as X-rays. However, some policies only cover some types of fillings. For instance, some might cover fillings with amalgam, but not composite, so as with all the dental procedures discussed here, make sure to get the information from your dentist and insurance company to fully understand your costs and coverage.[34]

Dental Crown Cost + Coverage

A crown is a porcelain or metal cap that is cemented on to entirely cover a damaged or weak tooth. You may need a crown because of a large cavity or an otherwise-damaged tooth. However, sometimes a crown is added to improve the look rather than the function of the tooth.[35]

Like some other dental procedures, the price of a dental crown depends on a number of variables, including the size, location and condition of the tooth; the materials used (metal, porcelain or a combination), local rates and the dentist’s price structure.[36]

So, how much is a crown? All-porcelain crowns are often the most expensive, followed by metal. The average cost of a metallic crown without insurance can range from $800-$2,100+.[37]

Does Dental Insurance Cover a Dental Crown?

Unless the crown is considered cosmetic, dental insurance probably will cover about 50% of the cost. Because the average cost of a crown can range from $800-$2,100, one crown could exceed some dental plans’ annual maximum benefit amount, which usually does not exceed $2,00.[38]

Root Canal Cost + Coverage

What actually is a root canal and why might you need one? The procedure is sometimes needed to save a tooth by eliminating bacteria from an infected root canal. During the procedure, the infected material is removed and the inside of the tooth is cleaned and disinfected, then filled and sealed.[39]

How much would these root canals cost without insurance? The cost of root canal surgery varies based on the type of tooth, with anterior teeth being easier to access and treat than molars. An anterior root canal costs $575 – $1,508+,[40] while a molar root canal costs $796 – $2,090+.[41] Root canals can be done by general dentists or by specialists called endodontists. Because they typically are called in for the more complex cases and have additional training, being treated by an endodontist may cost more.[42]

Does Dental Insurance Cover a Root Canal?

Most dental insurance plans will cover root canals and related expenses.[43] Root canals are usually covered at 50%. Some medical insurance will cover oral health expenses considered “medically necessary,” including treatment related to inflammation and infection and dental repair resulting from injury, so depending on why the root canal is needed, medical insurance coverage may be an option worth exploring.[44]

As with the other more costly dental procedures, if the cost of your root canal exceeds the annual benefit limit of your dental policy, you’ll be responsible for those costs.

How to Pay for Basic + Major Dental Procedures

How you pay for your dental care depends on a number of factors. If you think you’re likely to use the low- or no-cost preventive care, dental insurance is probably a good idea.

At the same time, it’s important to remember that most dental policies have an annual maximum benefit per person of $1,000-$1,500. So a policy only goes so far when facing the costs of basic and major dental procedures.

When deciding whether you could benefit from dental insurance, compare the cost of your annual premiums to your potential out-of-pocket costs for common procedures without insurance.[45]

Dental Insurance

Many people are able to get dental insurance through their employer. But if that’s not an option for you, you can enroll in a dental policy directly from an insurance carrier anytime during the year.

Dental premiums and deductibles are typically relatively affordable, with individual premiums averaging around $25 per month (2016)[46] and annual deductibles of around $50 (2016).[47]

If you’re comparing individual policies with a specific dental procedure in mind, make sure you review more than just your potential premiums and out-of-pocket costs. For example, you’ll want to ensure that:

  • Your dentist, or another convenient provider, is in the policy’s network
  • There isn’t a waiting period for procedures that you’re seeking coverage for[48]
  • You understand what the policy’s annual maximum benefit limit is and how that impacts your overall costs

For example, if your child needs to have four impacted wisdom teeth extracted and your dentist or oral surgeon has indicated that it will cost $400 per tooth, you’re facing around $1,600 for the procedure.

If your policy has a $50 deductible, $1,000 annual maximum benefit limit, and classifies this procedure as a “basic” procedure (covering it at 80%), the costs breakdown works out as follows:

Example: Total Out of Pocket Costs for Wisdom Teeth Extraction*

You Pay Your Policy Pays
Deductible $50
Basic 80/20 Coinsurance $310 (20%) $1,240 (80%)
Annual Benefit Limit Adjustment $240 -$240
Total $600 $1,000 (annual benefit limit)

* Note that many dental policies include office visit copays that you are also responsible for.

Want to compare dental plans, coverage options and costs?

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Medicare and Medicaid

Medicare doesn’t cover most dental care. Part A will pay for certain dental services that you get when you’re in a hospital. But Part A can pay for hospital stays if you need to have emergency or complicated dental procedures, even though the dental care isn’t covered.[49]

Learn more about dental insurance options for seniors.

Medicaid in most states provides emergency dental services for adults, but less than half of the states currently provide comprehensive dental care.[50]

Other Options to Help With Out-of-Pocket Costs

Even with insurance coverage, some dental procedures result in significant costs. There may be other ways to reduce your out-of-pocket costs or help make it easier to pay. These options may include:

  • Dental discount or savings plans
  • Dental schools or walk-in clinics
  • Financing through your dentist if they offer a discount for paying the full cost up front or if they offer an option to pay in installments[51]
  • HSA or FSA funds often may be used for dental services like x-rays, fillings, braces and extractions[52]
  • If your procedure is considered “medically necessary,” your medical insurance may pick up part of the bill, so be sure to check with your dentist and your medical insurance provider[53]

Summary + Next Steps

More extensive dental care, from chipped tooth repair to a root canal may be necessary to help maintain your tooth and gum health. However, the costs of such procedures can add up. Having dental insurance to help cover some of the costs can make things a bit easier.

You can get a dental insurance quote today. Or call 888-855-6837 to speak with an insurance agent to discuss your options for coverage.

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