Plan Information

AmeriPlan® Dental Plus Fee Schedule

The AmeriPlan® Dental Plus program gives you immediate savings on Dental, Vision, Prescription and Chiropractic services.

Dental

:
  • Choose from over 75,000 dental providers in the AmeriPlan network.
  • 15% to 80% savings on dental procedures performed by a Program dentist.
  • Special savings on specialist work such as braces, oral surgery, root canals, gum treatment and childrens dentistry.
  • All on-going dental problems are accepted except for orthodontic treatment in progress.
  • Please click here for Dental Program Details

Vision:

  • More than 12,000 optical providers nationwide including most national chains such as LensCrafters, Pearle Vision, Sears and JC Penney.
  • Save from 10% to 55% on ophthalmology eye exams and LASIK surgery with certain providers in selected markets.
  • Save 10% to 20% on contact lenses (excluding disposables) at participating retail locations
  • Please click here for Vision Program Details.

Prescription:

  • More than 56,000 retail pharmacy locations across the country*, including most national chain pharmacies, such as CVS, Wal-mart, Target and Walgreens participate in the AmeriPlan program.
  • Save 10%-85% on most brand name and generic prescription drugs.** Special savings on most high-volume and maintenance-type drugs.***
  • Please click here for Prescription Program Details.

Chiropractic:

  • 30%-50% savings on chiropractic care through our network of more than 7,500 private chiropractors.
  • Free initial consultation. 50% savings on diagnostic services and x-rays (if necessary).
  • Please click here for Chiropractic Program Details.

This is a Discount Medical Program, NOT INSURANCE, you are responsible for payment of provider fees for services.

For complete Fee Schedule details in your area, please click here

Plan Features
Diagnostic
Clinical Oral Evaluation You Pay
D0110 comprehensive oral evaluation discount
D0120 periodic oral evaluation - established patient $15
D0130 limited oral evaluation-problem focused discount
D0140 limited oral evaluation - problem focused $25
D0145 oral evaluation for a patient under three years of age and counseling with primary caregiver discount
D0150 comprehensive oral evaluation - new or established patient $39
D0160 detailed and extensive oral evaluation - problem focused, by report discount
D0170 re-evaluation - limited, problem focused (established patient; not post-operative visit) discount
D0180 comprehensive periodontal evaluation - new or established patient $37
Radiographs/Diagnostic Imaging (Including Interpretation) You Pay
D0210 intraoral - complete series (including bitewings) $65
D0220 intraoral - periapical first film $16
D0230 intraoral - periapical each additional film $11
D0240 intraoral - occlusal film $17
D0250 extraoral - first film discount
D0260 extraoral - each additional film discount
D0270 bitewing - single film $15
D0272 bitewings - two films $24
D0273 bitewings - three films $29
D0274 bitewings - four films $34
D0277 vertical bitewings - 7 to 8 films discount
D0330 panoramic film $55
D0340 cephalometric film discount
D0350 oral/facial photographic images discount
Tests and Examinations You Pay
D0415 collection of microorganisms for culture and sensitivity discount
D0431 adjunctive pre-diagnostic test that aids in dection of mucosal abnormalities including premalignant and malignant lesions, not to incluede cytology or biopsy procedures discount
D0460 pulp vitality tests $25
D0470 diagnostic casts $45
Oral Pathology Laboratory You Pay
D0472 accession of tissue, gross examination, preparation and transmission of written report discount
D0473 accession of tissue, gross and microscopic examination, preparation and transmission of written report discount
D0474 accession of tissue, gross and microscopic examination, including assessment of surgical margins for presence of disease, preparation and transmission of written report discount
D0486 accession of transepithelial cytologic sample, microscopic examination, preparation and transmission of written report discount
Clinical Oral Evaluation You Pay
D0999A office visit fee - per visit discount
Preventive
Dental Prophylaxis You Pay
D1110 prophylaxis - adult $53
D1120 prophylaxis - child $42
Topical Fluoride Treatment (Office Procedure) You Pay
D1201 topical application of fluoride (including prophylaxis) - child discount
D1203 topical application of fluoride - child discount
D1204 topical application of fluoride - adult discount
D1205 topical application of fluoride (including prophylaxis) - adult discount
D1206 topical fluoride varnish; therapeutic application for moderate to high caries risk patients $25
Other Preventive Services You Pay
D1310 nutritional counseling for control of dental disease discount
D1320 tobacco counseling for the control and prevention of oral disease discount
D1330 oral hygiene instructions $15
D1351 sealant - per tooth $32
D1352 preventive resin restoration in a moderate to high caries risk patient - permanent tooth discount
Space Maintenance (Passive Appliances) You Pay
D1510 space maintainer - fixed - unilateral $200
D1515 space maintainer - fixed - bilateral $225
D1520 space maintainer - removable - unilateral discount
D1525 space maintainer - removable - bilateral discount
D1550 re-cementation of space maintainer discount
D1555 removal of fixed space maintainer discount
Restorative
Amalgam Restorations (Including Polishing) You Pay
D2110 amalgam-one surface, primary discount
D2120 amalgam-two surfaces, primary discount
D2130 amalgam-three surfaces, primary discount
D2131 amalgam-four or more surfaces, primary discount
D2140 amalgam - one surface, primary or permanent $70
D2150 amalgam - two surfaces, primary or permanent $80
D2160 amalgam - three surfaces, primary or permanent $95
D2161 amalgam - four or more surfaces, primary or permanent discount
Resin - Based Composite Restorations - Direct You Pay
D2330 resin-based composite - one surface, anterior $95
D2331 resin-based composite - two surfaces, anterior $115
D2332 resin-based composite - three surfaces, anterior $140
D2335 resin-based composite - four or more surfaces or involving incisal angle (anterior) discount
D2380 resin-one surface, posterior-primary discount
D2381 resin-two surfaces, posterior-primary discount
D2382 resin-three or more surfaces, posterior-primary discount
D2385 resin-one surface, posterior-permanent discount
D2386 resin-two surfaces, posterior-permanent discount
D2387 resin-three or more surfaces, posterior-permanent discount
D2390 resin-based composite crown, anterior discount
D2391 resin-based composite - one surface, posterior discount
D2392 resin-based composite - two surfaces, posterior discount
D2393 resin-based composite - three surfaces, posterior discount
D2394 resin-based composite - four or more surfaces, posterior discount
Gold Foil Restorations You Pay
D2410 gold foil - one surface discount
D2420 gold foil - two surfaces discount
Inlay/Onlay Restorations You Pay
D2510 inlay - metallic - one surface discount
D2520 inlay - metallic - two surfaces discount
D2530 inlay - metallic - three or more surfaces discount
D2542 onlay - metallic-two surfaces discount
D2543 onlay - metallic-three surfaces discount
D2544 onlay - metallic-four or more surfaces discount
D2610 inlay - porcelain/ceramic - one surface discount
D2620 inlay - porcelain/ceramic - two surfaces discount
D2630 inlay - porcelain/ceramic - three or more surfaces discount
D2642 onlay - porcelain/ceramic - two surface discount
D2643 onlay - porcelain/ceramic - three surfaces discount
D2644 onlay - porcelain/ceramic - four or more surfaces discount
D2650 inlay - resin-based composite - one surface discount
D2651 inlay - resin-based composite - two surfaces discount
D2652 inlay - resin-based composite - three or more surfaces discount
D2662 onlay - resin-based composite - two surfaces discount
D2663 onlay - resin-based composite - three surfaces discount
D2664 onlay - resin-based composite - four or more surfaces discount
Crowns - Single Restorations Only You Pay
D2710 crown - resin-based composite (indirect) discount
D2712 crown - 3/4 resin-based composite (indirect) discount
D2720 crown - resin with high noble metal discount
D2721 crown - resin with predominantly base metal discount
D2722 crown - resin with noble metal discount
D2740 crown - porcelain/ceramic substrate discount
D2750 crown - porcelain fused to high noble metal $575
D2751 crown - porcelain fused to predominantly base metal $450
D2752 crown - porcelain fused to noble metal $525
D2780 crown - 3/4 cast high noble metal discount
D2781 crown - 3/4 cast predominantly base metal discount
D2782 crown - 3/4 cast noble metal discount
D2783 crown - 3/4 porcelain/ceramic discount
D2790 crown - full cast high noble metal $550
D2791 crown - full cast predominantly base metal $450
D2792 crown - full cast noble metal $475
D2794 crown - titanium discount
D2799 crown - provisional crown discount
D2810 crown 3/4 porcelain ceramic discount
Other Restorative Services You Pay
D2910 recement inlay, onlay, or partial coverage restoration $50
D2915 recement cast or prefabricated post and core discount
D2920 re-cement crown $50
D2930 prefabricated stainless steel crown - primary tooth $135
D2931 prefabricated stainless steel crown - permanent tooth $150
D2932 prefabricated resin crown $155
D2933 prefabricated stainless steel crown with resin window discount
D2934 prefabricated esthetic coated stainless steel crown - primary tooth discount
D2940 protective restoration $55
D2950 core buildup, including any pins discount
D2951 pin retention - per tooth, in addition to restoration $30
D2952 post and core in additon to crown, indirectly fabricated discount
D2953 each additonal indirectly fabricated post - same tooth discount
D2954 prefabricated post and core in addition to crown discount
D2955 post removal (not in conjunction with endodontic therapy) discount
D2957 each additonal prefabricated post - same tooth discount
D2960 labial veneer (resin laminate) - chairside discount
D2961 labial veneer (resin laminate) - laboratory discount
D2962 labial veneer (porcelain laminate) - laboratory discount
D2970 temporary crown (fractured tooth) discount
D2971 additional procedures to construct new crown under existing partial denture framework discount
D2975 coping discount
D2980 crown repair, by report discount
Endodontics
Pulp Capping You Pay
D3110 pulp cap - direct (excluding final restoration) $42
D3120 pulp cap - indirect (excluding final restoration) $42
Pulpotomy You Pay
D3220 therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction and application of medicament $90
D3221 pulpal debridement, primary and permanent teeth discount
D3222 partial pulpotomy for apexogenesis - permanent tooth with incomplete root development discount
Endodontic Therapy on Primary Teeth You Pay
D3230 pulpal therapy (resorbable filling) - anterior, primary tooth (excluding final restoration) discount
D3240 pulpal therapy (resorbable filling) - posterior, primary tooth (excluding final restoration) discount
Endodontic Therapy (Including Treatment Plan, Clinical Procedures and Follow-Up Care) You Pay
D3310 endodontic therapy, anterior tooth (excluding final restoration) $400
D3320 endodontic therapy, bicuspid tooth (excluding final restoration) $440
D3330 endodontic therapy, molar (excluding final restoration) discount
D3331 treatment of root canal obstruction; non-surgical access discount
D3332 incomplete endodontic therapy; inoperable, unrestorable or fractured tooth discount
D3333 internal root repair of perforation defects discount
Endodontic Retreatment You Pay
D3346 retreatment of previous root canal therapy - anterior discount
D3347 retreatment of previous root canal therapy - bicuspid discount
D3348 retreatment of previous root canal therapy - molar discount
Apexification/Recalcification Procedures You Pay
D3351 apexification/recalcification/pulpal regeneration - initial visit (apical closure/calcific repair of perforations, root resorption, pulp space disinfection, etc.) discount
D3352 apexification/recalcification/pulpal regeneration - interim medication replacement (apical closure/calcific repair of perforations, root resorption, pulp space disinfection, etc.) discount
D3353 apexification/recalcification - final visit (includes completed root canal therapy -apical closure/calcific repair of perforations, root resorption, etc.) discount
Apicoectomy/Periradicular Services You Pay
D3410 apicoectomy/periradicular surgery - anterior discount
D3421 apicoectomy/periradicular surgery - bicuspid (first root) discount
D3425 apicoectomy/periradicular surgery - molar (first root) discount
D3426 apicoectomy/periradicular surgery (each additonal root) discount
D3430 retrograde filling - per root discount
D3450 root amputation - per root discount
Other Endodontic Procedures You Pay
D3920 hemisection (including any root removal), not including root canal therapy discount
D3950 canal preparation and fitting of preformed dowel or post discount
Periodontics
Surgical Services (Including Usual Postoperative Care) You Pay
D4210 gingivectomy or gingivoplasty - four or more contiguous teeth or tooth bounded spaces per quadrant discount
D4211 gingivectomy or gingivoplasty - one to three contiguous teeth or tooth bounded spaces per quadrant discount
D4220 gingival curettage, surgical, per quadrant, by report discount
D4230 anatomical crown exposure - four or more contiguous teeth per quadrant discount
D4231 anatomical crown exposure - one to three teeth per quadrant discount
D4240 gingival flap procedure, including root planing - four or more contiguous teeth or tooth bounded spaces per quardant discount
D4241 gingival flap procedure, including root planing - one to three contiguous teeth or tooth bounded spaces per quardant discount
D4245 apically positioned flap discount
D4249 clinical crown lengthening - hard tissue discount
D4250 mucogingival surgery-per quadrant discount
D4260 osseous surgery (including flap entry and closure) - four or more contiguous teeth or tooth bounded spaces per quadrant discount
D4261 osseous surgery (including flap entry and closure) - one to three teeth contiguous teeth or tooth bounded spaces per quadrant discount
D4263 bone replacement graft - first site in quadrant discount
D4264 bone replacement graft - each additonal site in quadrant discount
D4265 biologic materials to aid in soft and osseous tissue regeneration discount
D4266 guided tissue regeneration - resorbable barrier, per site discount
D4267 guided tissue regeneration - nonresorbable barrier, per site (includes membrane removal) discount
D4268 surgical revision procedure, per tooth discount
D4270 pedicle soft tissue graft procedure discount
D4271 free soft tissue graft procedure (including donor site surgery) discount
D4273 subepithelial connective tissue graft procedures, per tooth discount
D4274 distal or proximal wedge procedure (when not performed in conjunction with surgical procedures in the same anatomical area) discount
D4275 soft tissue allograft discount
D4276 combined connective tissue and double pedicle graft, per tooth discount
Non-Surgical Periodontal Service You Pay
D4320 provisional splinting - intracoronal discount
D4321 provisional splinting - extracoronal discount
D4341 periodontal scaling and root planing - four or more teeth per quadrant discount
D4342 periodontal scaling and root planing - one to three teeth per quadrant discount
D4345 periodontal scaling in the presence of gingival inflammation discount
D4355 full mouth debridement to enable comprehensive evaluation and diagnosis $102
D4381 localized delivery of antimicrobial agents via a controlled release vehicle into diseased crevicular tissue, per tooth, by report discount
Other Periodontal Services You Pay
D4910 periodontal maintenance $70
D4920 unscheduled dressing change (by someone other than treating dentist) discount
Prosthodontics (removable)
Complete Dentures (Including Routine Post-Delivery Care) You Pay
D5110 complete denture - maxillary $750
D5120 complete denture - mandibular $750
D5130 immediate denture - maxillary $750
D5140 immediate denture - mandibular $750
Partial Dentures (Including Routine Post-Delivery Care) You Pay
D5211 maxillary partial denture - resin base (including any conventional clasps, rests and teeth) $565
D5212 mandibular partial denture - resin base (including any conventional clasps, rests and teeth) $565
D5213 maxillary partial denture - cast metal framework with resin denture bases (including any conventional clasps, rests and teeth) discount
D5214 mandibular partial denture - cast metal framework with resin denture bases (including any conventional clasps, rests and teeth) discount
D5225 maxillary partial denture - flexible base (including any clasps, rests and teeth) discount
D5226 mandibular partial denture - flexible base (including any clasps, rests and teeth) discount
D5281 removable unilateral partial denture - one piece cast metal (including clasps and teeth) discount
Adjustments to Dentures You Pay
D5410 adjust complete dentures - maxillary $40
D5411 adjust complete dentures - mandibular $40
D5421 adjust partial denture - maxillary $40
D5422 adjust partial denture - mandibular $40
Repairs to Complete Dentures You Pay
D5510 repair broken complete denture base discount
D5520 replace missing or broken teeth - complete denture (each tooth) discount
Repairs to Partial Dentures You Pay
D5610 repair resin denture base discount
D5620 repair cast framework discount
D5630 repair or replace broken clasp discount
D5640 replace broken teeth - per tooth discount
D5650 add tooth to existing partial denture discount
D5660 add clasp to existing partial denture discount
D5670 replace all teeth and acrylic on cast metal framework (maxillary) discount
D5671 replace all teeth and acrylic on cast metal framework (mandibular) discount
Denture Rebase Procedures You Pay
D5710 rebase complete maxillary denture $315
D5711 rebase complete mandibular denture $315
D5720 rebase maxillary partial denture $290
D5721 rebase mandibular partial denture $290
Denture Reline Procedures You Pay
D5730 reline complete maxillary denture (chairside) discount
D5731 reline complete mandibular denture (chairside) discount
D5740 reline maxillary partial denture (chairside) discount
D5741 reline mandibular partial denture (chairside) discount
D5750 reline complete maxillary denture (laboratory) discount
D5751 reline complete mandibular denture (laboratory) discount
D5760 reline maxillary partial denture (laboratory) discount
D5761 reline mandibular partial denture (laboratory) discount
Interim Prosthesis You Pay
D5810 interim complete denture (maxillary) discount
D5811 interim complete denture (mandibular) discount
D5820 interim partial denture (maxillary) discount
D5821 interim partial denture (mandibular) discount
Other Removable Prosthetic Services You Pay
D5850 tissue conditioning, maxillary discount
D5851 tissue conditioning, mandibular discount
D5860 overdenture - complete, by report discount
D5861 overdenture - partial, by report discount
D5862 precision attachment, by report discount
Maxillofacial Prosthetics
Maxillofacial Prosthetics You Pay
D5982 surgical stent discount
Implant Services
Implant Services You Pay
D6000A implant services discount
D6010 surgical placement of implant body: endosteal implant discount
D6012 surgical placement of interim implant body for transitional prosthesis: endosteal implant discount
Implant Supported Prosthetics You Pay
D6053 implant/abutment supported removable denture for completely edentulous arch discount
D6054 implant/abutment supported removable denture for partially edentulous arch discount
D6056 prefabricated abutment - includes placement discount
D6057 custom abutment - includes placement discount
D6058 abutment supported porcelain/ceramic crown discount
D6059 abutment supported porcelain fused to metal crown (high noble metal) discount
D6060 abutment supported porcelain fused to metal crown (predominantly base metal) discount
D6061 abutment supported porcelain fused to metal crown (noble metal) discount
D6062 abutment supported cast metal crown (high noble metal) discount
D6063 abutment supported cast metal crown (predominantly base metal) discount
D6064 abutment supported cast metal crown (noble metal) discount
D6065 implant supported porcelain/ceramic crown discount
D6066 implant supported porcelain fused to metal crown (titanium, titanium alloy, high noble metal) discount
D6067 implant supported metal crown (titanium, titanium alloy, high noble metal) discount
D6068 abutment supported retainer for porcelain/ceramic FPD discount
D6069 abutment supported retainer for porcelain fused to metal FPD (high noble metal) discount
D6070 abutment supported retainer for porcelain fused to metal FPD (predominantly base metal) discount
D6071 abutment supported retainer for porcelain fused to metal FPD (noble metal) discount
D6072 abutment supported retainer for cast metal FPD (high noble metal) discount
D6073 abutment supported retainer for cast metal FPD (predominantly base metal) discount
D6074 abutment supported retainer for cast metal FPD (noble metal) discount
D6075 implant supported retainer for ceramic FPD discount
D6076 implant supported retainer for porcelain fused to metal FPD (titanium, titanium alloy, or high noble metal) discount
D6077 implant supported retainer for cast metal FPD (titanium, titanium alloy, or high noble metal) discount
Other Implant Services You Pay
D6092 recement implant/abutment supported crown discount
D6093 recement implant/abutment supported fixed partial denture discount
Implant Supported Prosthetics You Pay
D6094 abutment supported crown - (titanium) discount
D6194 abutment supported retainer crown for FPD - (titanium) discount
Prosthodontics, fixed
Fixed Partial Denture Pontics You Pay
D6205 pontic - indirect resin based composite discount
D6210 pontic - cast high noble metal discount
D6211 pontic - cast predominantly base metal discount
D6212 pontic - cast noble metal discount
D6214 pontic - titanium discount
D6240 pontic - porcelain fused to high noble metal discount
D6241 pontic - porcelain fused to predominantly base metal discount
D6242 pontic - porcelain fused to noble metal discount
D6245 pontic - porcelain/ceramic discount
D6250 pontic - resin with high noble metal discount
D6251 pontic - resin with predominantly base metal discount
D6252 pontic - resin with noble metal discount
D6253 provisional pontic discount
Fixed Partial Denture Retainers-Inlays/Onlays You Pay
D6545 retainer - cast metal for resin bonded fixed prosthesis discount
D6548 retainer - porcelain/ceramic for resin bonded fixed prosthesis discount
D6600 inlay - procelain/ceramic, two surfaces discount
D6601 inlay - porcelain/ceramic, three or more surfaces discount
D6602 inlay - cast high noble metal, two surfaces discount
D6603 inlay - cast high noble metal, three or more surfaces discount
D6604 inlay - cast predominantly base metal, two surfaces discount
D6605 inlay - cast predominantly base metal, three or more surfaces discount
D6606 inlay - cast noble metal, two surfaces discount
D6607 inlay - cast noble metal, three or more surfaces discount
D6608 onlay - porcelain/ceramic, two surfaces discount
D6609 onlay - porcelain/ceramic, three or more surfaces discount
D6610 onlay - cast high noble metal, two surfaces discount
D6611 onlay - cast high noble metal, three or more surfaces discount
D6612 onlay - cast predominantly base metal, two surfaces discount
D6613 onlay - cast predominantly base metal, three or more surfaces discount
D6614 onlay - cast noble metal, two surfaces discount
D6615 onlay - cast noble metal, three or more surfaces discount
D6624 inlay - titanium discount
D6634 onlay - titanium discount
Fixed Partial Denture Retainers-Crowns You Pay
D6710 crown - indirect resin based composite discount
D6720 crown - resin with high noble metal discount
D6721 crown - resin with predominantly base metal discount
D6722 crown - resin with noble metal discount
D6740 crown - porcelain/ceramic discount
D6750 crown - porcelain fused to high noble metal discount
D6751 crown - porcelain fused to predominantly base metal discount
D6752 crown - porcelain fused to noble metal discount
D6780 crown - 3/4 cast high noble metal discount
D6781 crown - 3/4 cast predominantly base metal discount
D6782 crown - 3/4 cast noble metal discount
D6783 crown - 3/4 porcelain/ceramic discount
D6790 crown - full cast high noble metal discount
D6791 crown - full cast predominantly base metal discount
D6792 crown - full cast noble metal discount
D6793 provisional retainer crown discount
D6794 crown - titanium discount
Other Fixed Partial Denture Services You Pay
D6930 re-cement fixed partial denture $80
D6940 stress breaker discount
D6950 precision attachment discount
D6970 post and core in addition to fixed partial denture retainer, indirectly fabricated discount
D6971 cast post as part of fixed partial denture retainer discount
D6972 prefabricated post and core in addition to fixed partial denture retainer discount
D6973 core build up for retainer, including any pins discount
D6975 coping - metal discount
D6976 each additional indirectly fabricated post - same tooth discount
D6977 each additional prefabricated post - same tooth discount
D6980 fixed partial denture repair, by report discount
Oral and Maxillofacial Surgery
Extractions (Includes Local Anesthesia, Suturing, if Needed, and Routine Postoperative Care) You Pay
D7110 single tooth discount
D7111 extraction, coronal remnants - deciduous tooth $60
D7120 each additional tooth discount
D7140 extraction, erupted tooth or exposed root (elevation and/or forceps removal) $75
Surgical Extractions (Includes Local Anesthesia, Suturing, If Needed, and Routine Postoperative Care You Pay
D7210 surgical removal of erupted tooth requiring elevation of mucoperiosteal flap and removal of bone and/or section of tooth. $140
D7220 removal of impacted tooth - soft tissue $160
D7230 removal of impacted tooth - partially bony $210
D7240 removal of impacted tooth - completely bony discount
D7241 removal of impacted tooth - completely bony, with unusual surgical complications discount
D7250 surgical removal of residual tooth roots (cutting procedure) discount
Other Surgical Prodecures You Pay
D7260 oroantral fistula closure discount
D7261 primary closure of a sinus perforation discount
D7270 tooth reimplantation and/or stabilization of accidentally evulsed or displaced tooth discount
D7272 tooth transplantation (includes reimplantation from one site to another and splinting and/or stabilization) discount
D7280 surgical access of an unerupted tooth discount
Periodontics
Surgical Services (Including Usual Postoperative Care) You Pay
D7281 Surgical exposure of impacted or unerupted tooth to aid eruption discount
Oral and Maxillofacial Surgery
Other Surgical Prodecures You Pay
D7282 mobilization of erupted or malpositioned tooth to aid eruption discount
D7285 biopsy of oral tissue - hard (bone, tooth) discount
D7286 biopsy of oral tissue - soft discount
D7287 exfoliative cytological sample collection discount
D7288 brush biopsy - transepithelial sample collection discount
D7291 transseptal fiberotomy/supra crestal fiberotomy, by report discount
Alveoloplasty-Surgical Preparation of Ridge for Dentures You Pay
D7310 alveoloplasty in conjunction with extractions - four or more teeth or tooth spaces, per quadrant discount
D7311 alveoloplasty in conjunction with extractions - one to three teeth or tooth spaces, per quadrant discount
D7320 alveoloplasty not in conjuction with extractions - four or more teeth or tooth spaces, per quadrant discount
D7321 alveoloplasty not in conjuction with extractions - one to three teeth or tooth spaces, per quadrant discount
Vestibuloplasty You Pay
D7340 vestibuloplasty - ridge extension (secondary epithelialization) discount
D7350 vestibuloplasty - ridge extension (including soft tissue grafts, muscle reattachment, revision of soft tissue attachment and management of hypertrophied and hyperplastic tissue) discount
Surgical Excision of Soft Tissue Lesions You Pay
D7410 excision of benign lesion up to 1.25 cm discount
D7411 excision of benign lesion greater than 1.25 cm discount
D7412 excision of benign lesion, complicated discount
D7413 excision of malignant lesion up to 1.25 cm discount
D7414 excision of malignant lesion greater than 1.25 cm discount
D7415 excision of malignant lesion, complicated discount
Surgical Excision of Intra-Osseous Lesions You Pay
D7440 excision of malignant tumor - lesion diameter up to 1.25 cm discount
D7441 excision of malignant tumor - lesion diameter greater than 1.25 cm discount
D7450 removal of benign odontogenic cyst or tumor - lesion diameter up to 1.25 cm discount
D7451 removal of benign odontogenic cyst or tumor - lesion diameter greater than 1.25 cm discount
D7460 removal of benign nonodontogenic cyst or tumor - lesion diameter up to 1.25 cm discount
D7461 removal of benign nonodontogenic cyst or tumor - lesion diameter greater than 1.25 cm discount
Surgical Excision of Soft Tissue Lesions You Pay
D7465 destruction of lesion(s) by physical or chemical method, by report discount
Excision of Bone Tissue You Pay
D7471 removal of lateral exostosis (maxilla or mandible) discount
D7472 removal of torus palatinus discount
D7473 removal of torus mandibularis discount
D7485 surgical reduction of osseous tuberosity discount
Surgical Incision You Pay
D7510 incision and drainage of abscess - intraoral soft tissue discount
D7511 incision and drainage of abscess - intraoral soft tissue - complicated (includes drainage of multiple fascial spaces) discount
D7520 incision and drainage of abscess - extraoral soft tissue discount
D7530 removal of foreign body from mucosa, skin, or subcutaneous alveolar tissue discount
D7540 removal of reaction producing foreign bodies, musculoskeletal system discount
D7550 partial ostectomy/sequestrectomy for removal of non-vital bone discount
D7560 maxillary sinusotomy for removal of tooth fragment or foreign body discount
Reduction of Dislocation and Management of Other Temporomandibular Joint Dysfuctions You Pay
D7880 occlusal orthotic device, by report discount
Repair of Traumatic Wounds You Pay
D7910 suture of recent small wounds up to 5 cm discount
Complicated Suturing (Reconstruction Requiring Delicate Handling of Tissues and Wide Undermining for You Pay
D7911 complicated suture - up to 5 cm discount
D7912 complicated suture - greater than 5 cm discount
Other Repair Procedures You Pay
D7953 bone replacement graft for ridge preservation - per site discount
D7960 frenulectomy (frenectomy or frenotomy) - separate procedure discount
D7963 frenuloplasty discount
D7970 excision of hyperplastic tissue - per arch discount
D7971 excision of pericoronal gingiva discount
D7972 surgical reduction of fibrous tuberosity discount
D7980 sialolithotomy discount
D7983 closure of salivary fistula discount
Orthodontics
Limited Orthodontic Treatment You Pay
D8010 limited orthodontic treatment of the primary dentition discount
D8020 limited orthodontic treatment of the transitional dentition discount
D8040 limited orthodontic treatment of the adult dentition discount
Interceptive Orthodontic Treatment You Pay
D8050 interceptive orthodontic treatment of the primary dentition discount
D8060 interceptive orthodontic treatment of the transitional dentition discount
Comprehensive Orthodontic Treatment You Pay
D8070 comprehensive orthodontic treatment of the transitional dentition discount
D8080 comprehensive orthodontic treatment of the adolescent dentition $2300
D8090 comprehensive orthodontic treatment of the adult dentition $2450
Minor Treatment to Control Harmful Habits You Pay
D8210 removable appliance therapy $375
D8220 fixed appliance therapy $550
Other Orthodontic Services You Pay
D8660 pre-orthodontic treatment visit $255
D8680 orthodontic retention (removal of appliances, construction and placement of retainer(s)) discount
Adjunctive General Services
Unclassified Treatment You Pay
D9110 palliative (emergency) treatment of dental pain-minor procedure $55
D9120 fixed partial denture sectioning discount
Anesthesia You Pay
D9210 local anesthesia not in conjunction with operative or surgical procedures discount
D9211 regional block anesthesia discount
D9212 trigeminal division block anesthesia discount
D9215 local anesthesia discount
D9220 deep sedation/general anesthesia-first 30 minutes discount
D9221 deep sedation/general anesthesia-each additional 15 minutes discount
D9230 analgesia, anxiolysis, inhalation of nitrous oxide discount
D9241 intravenous conscious sedation/analgesia-first 30 minutes discount
D9242 intravenous conscious sedation/analgesia-each additional 15 minutes discount
D9248 non-intravenous conscious sedation discount
Professional Consultation You Pay
D9310 consultation - diagnostic service provided by dentist or physician other than requesting dentist or physician $50
Professional Visits You Pay
D9430 office visit for observation (during regularly scheduled hours)-no other services performed $35
D9440 office visit-after regularly scheduled hours $85
D9450 case presentation, detailed and extensive treatment planning discount
Drugs You Pay
D9610 therapeutic parenteral drug, single administration discount
D9612 therapeutic parenteral drug, two or more administrations, different medications discount
D9630 other drugs and/or medicaments, by report discount
Miscellaneous Services You Pay
D9910 application of desensitizing medicament discount
D9911 application of desensitizing resin for cervical and/or root surface, per tooth discount
D9930 treatment of complications (post-surgical) - unusual circumstances, by report discount
D9940 occlusal guard, by report discount
D9941 fabrication of athletic mouthguard discount
D9942 repair and/or reline of occlusal guard discount
D9951 occlusal adjustment - limited discount
D9952 occlusal adjustment - complete discount
D9970 enamel microabrasion discount
D9971 odontoplasty 1-2 teeth; includes removal of enamel projections discount
D9972 external bleaching - per arch discount
D9973 external bleaching - per tooth discount
D9974 internal bleaching - per tooth discount
D9999 unspecified adjunctive procedure, by report discount

This is a Discount Medical Program, NOT INSURANCE, you are responsible for payment of provider fees for services.
* Discounts available only at participating pharmacies.
** You may not receive a savings on some high-volume or maintenance-type drugs since these medications may have already been reduced at the pharmacy level.
*** Available through mail order program.

Disclaimer:
The discount medical plans of AmeriPlan® offer a reduction in the cost of medical, dental, vision, pharmaceutical and chiropractic services. AmeriPlan® discount benefit programs are not insurance, nor are they an alternative to or substitution for insurance coverage. Since they are not health insurance, members must use AmeriPlan® providers and members are responsible for payment to the AmeriPlan® providers at point of service of discount healthcare fees incurred. If you currently have insurance, you should be aware that canceling that policy may make it difficult to later obtain coverage. AmeriPlan® recommends that you speak to your insurance agent or your company's insurance administrator before canceling any health insurance policy for any reason.