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Advanced Practice Management
7101 York Avenue South, Suite 300 Edina, Minnesota 55435-4407
Contact Us Today (952) 921-3360
Metro Area And Rochester Outstate Area
CODE Procedure Mean 95%tile 75%tile 5%tile Range of Certainty* Mean 95%tile 75%tile 5%tile Range of Certainty*
0120 Periodic Exam $50 $57 $52 $43 1% $43 $51 $47 $33 2%
0140 Emergency Exam $72 $94 $76 $49 3% $59 $76 $67 $40 3%
0150 Comprehensive Exam $78 $96 $83 $59 2% $65 $88 $71 $47 3%
1110 Adult Prophy $92 $103 $96 $80 1% $80 $94 $86 $63 2%
1120 Child Prophy $65 $74 $68 $55 1% $55 $65 $60 $43 2%
0220 PA 1st Film $29 $34 $31 $24 2% $26 $31 $29 $20 2%
0272 2 Bitewings $47 $52 $49 $39 2% $41 $49 $44 $31 2%
0274 4 Bitewings $60 $68 $64 $50 1% $55 $65 $58 $43 2%
0210 FMX $131 $152 $138 $112 2% $120 $150 $130 $95 2%
0330 Panoramic Film $120 $137 $125 $102 1% $104 $121 $111 $85 2%
1206 Fluoride Varnish $41 $52 $45 $28 3% $35 $47 $39 $25 3%
1208 Fluoride $41 $49 $44 $29 3% $34 $42 $38 $24 3%
1351 Sealant (EACH) $52 $60 $55 $44 2% $45 $53 $48 $35 2%
Amalgams (Permanent):
2140 1 Surface $134 $178 $142 $112 3% $113 $1345 $121 $87 2%
2150 2 Surfaces $173 $244 $180 $144 3% $144 $184 $155 $110 2%
2160 3 Surfaces $212 $297 $216 $177 3% $176 $222 $188 $132 3%
2161 4 Surfaces $262 $356 $275 $213 3% $215 $280 $233 $158 3%
Anterior Composites:
2330 1 Surface $159 $180 $166 $140 1% $134 $162 $143 $106 2%
2331 2 Surfaces $211 $246 $224 $180 2% $171 $215 $184 $130 2%
2332 3 Surfaces $262 $308 $275 $214 2% $207 $262 $225 $153 2%
2335 Resin involvingincisal Angle Class IV $307 $364 $324 $250 2% $249 $319 $273 $183 3%
Posterior Composites:
2391 1 Surface $174 $199 $182 $149 1% $148 $177 $157 $115 2%
2392 2 Surfaces $248 $285 $263 $205 2% $201 $245 $217 $152 2%
2393 3 Surfaces $308 $350 $325 $255 2% $249 $310 $270 $181 2%
2394 4 Surfaces $357 $417 $380 $286 2% $292 $370 $319 $209 3%
2630 Porcelain inlay $1,039 $1,224 $1,144 $799 3% $881 $1,095 $940 $677 3%
2643 Porcelain or
Ceramic Onlay
$1,073 $1,260 $1,174 $802 2% $924 $1,157 $988 $718 3%
2652 Composite inlay $940 $1,214 $1,061 $555 5% $768 $992 $917 $394 5%
Crowns:
2740 Ceramic Crown $1,164 $1,339 $1,235 $957 2% $975 $1,150 $1,038 $831 2%
2750 Porcelain fused to high noble $1,125 $1,290 $1,195 $948 1% $967 $1,150 $1,026 $800 2%
2751 Porcelain to
predom base metal
$1,069 $1,210 $1,140 $895 2% $915 $1,095 $972 $766 2%
2752 Porcelain to noble $1,101 $1,292 $1,165 $930 2% $932 $1,100 $993 $777 2%
2790 Full cast high noble $1,159 $1,344 $1,239 $972 2% $990 $1,200 $1,050 $810 2%
2791 Full cast predom base $1,046 $1,261 $1,130 $781 4% $905 $1,097 $962 $747 2%
2931 Stainless Steel $365 $500 $400 $256 4% $297 $394 $335 $198 5%
2950 Crown Build-up $278 $348 $300 $197 2% $225 $283 $250 $151 3%
2960 Labial Veneer (LAMINATE) $669 $1,102 $740 $368 5% $533 $952 $602 $250 6%
2962 Labial Veneer (PORCELAIN) $1,164 $1,490 $1,250 $881 3% $952 $1,258 $1,008 $731 3%
Endodontics:
3221 Open and Drain $216 $314 $240 $145 5% $158 $237 $182 $88 5%
3310 1 Canal $748 $865 $794 $637 2% $620 $745 $665 $480 2%
3320 2 Canals $870 $994 $912 $750 2% $724 $889 $773 $559 2%
3330 3 Canals $1,048 $1,200 $1,103 $890 1% $890 $1,047 $944 $712 2%
4341 Four or more Root Planing $281 $336 $295 $229 4% $233 $292 $252 $165 2%
4342 Root Planing (1-3) $194 $256 $220 $129 4% $158 $220 $176 $99 5%
4355 Debridement $218 $285 $240 $149 3% $171 $240 $195 $102 3%
4381 Arestin per Site $60 $143 $70 $30 9% $63 $157 $75 $31 10%
4381 Atridox Per Application $78 $163 $105 $30 13% $72 $159 $85 $35 13%
4910 Perio Maintenance $145 $171 $155 $109 2% $120 $149 $134 $87 2%
5120 LOWER Full Denture $1,886 $2,392 $1,994 $1,500 3% $1,525 $1,927 $1,670 $1,100 3%
5213 UPPER Partial $1,959 $2,404 $2,092 $1,549 3% $1,614 $2,064 $1,792 $1,145 3%
6010 Surgical Placement of Implant $1,949 $2,589 $2,200 $1,090 7% $1,779 $2,271 $1,996 $842 6%
6056 Prefabricated Abutment $675 $945 $800 $360 5% $639 $999 $749 $300 6%
6059 Abutment Sup Crown Implant $1,299 $1,621 $1,449 $1,000 3% $1,138 $1,526 $1,275 $843 4%
6066 Implant – Supp Crown-Porc to Metal $1,391 $2,020 $1,537 $995 4% $1,206 $1,693 $1,342 $856 4%
7140 Simple Extraction $175 $213 $184 $143 2% $145 $184 $157 $110 2%
8090 Invisalign $5,177 $6,262 $5,590 $3,500 4% $4,768 $6,083 $5,300 $3,200 7%
9110 Palliative Treatment $138 $204 $160 $74 5% $110 $185 $127 $58 5%
9972 Take Home Bleaching (Both Arches) $291 $487 $357 $131 6% $275 $500 $350 $90 6%
9999 In Office Bleaching (Both Arches) $476 $705 $583 $299 6% $444 $794 $518 $209 9%
*95% chance that the population mean is within plus or minus this percentage of the mean. Prepared By: Kern, DeWenter, Viere, Ltd. Certified Public Accountants Dental Practitioners — High and Low Ranges and Averages for years ending by March 31, 2012
Metro Area is defined as the seven county metro area.