Kinga Royer DMD


Family and Cosmetic Dentistry




 6116 S Tamiami Trl, Sarasota FL

941-922-6777

Office Fees

Here is a list of the most commonly used ADA/CDT codes and the standard fees of the office. In-network insurance fees will differ based on each insurance company and policy.

Exams

ADA Code Description   Fee

D0120 Periodic Oral Evaluation - established patient $70

D0140 Limited oral evaluation - problem focused $105

D0150 Comprehensive oral evaluation - new or established patient $125

X-rays

ADA Code Description   Fee

D0210 Intraoral - complete series of radiographic images $195

D0220 Intraoral - periapical first radiographic image $35

D0274 Bitewings - four radiographic images $85

Cleanings

ADA Code Description     Fee

D1111 Prophylaxis - adult $120

D1120 Prophylaxis - child $90

D4341 Periodontal scaling and root planing - four or more teeth per quadrant $340

D4342 Periodontal scaling and root planing - one to three teeth per quadrant $255

D4910 Periodontal maintenance $180

Fillings

ADA Code Description   Fee

D2330 Resin-based composite - one surface, front $225

D2331 Resin-based composite - two surfaces, front $270

D2332 Resin-based composite - three surfaces, front $330

D2335 Resin-based composite - four or more surfaces, front $415

D2391 Resin-based composite - one surface, back $245

D2392 Resin-based composite - two surfaces, back $310

D2393 Resin-based composite - three surfaces, back $380

D2394 Resin-based composite - four or more surfaces, back $445

Crowns/Bridges

ADA Code Description   Fee

D2740 Crown - porcelain/ceramic $1450

D2950 Core build-up, including any pins when required $350

D2954 Prefabricated post and core in addition to crown $430

D6065 Implant supported crown - porcelain/ceramic $1980

D6245 Pontic - porcelain/ceramic $1450

D6740 Retainer crown - porcelain/ceramic $1450

Extractions

ADA Code Description Fee

D7140 Extraction, erupted tooth or exposed root (elevation and/or forceps removal)     $275

D7210 Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth,   $375

and including elevation of mucoperiosteal flap if indicated

Root Canals

ADA Code Description     Fee

D3310 Endodontic therapy, anterior tooth (excluding final restoration) $990

D3320 Endodontic therapy, premolar tooth (excluding final restoration) $1145

D3330 Endodontic therapy, molar tooth (excluding final restoration) $1360

Dentures/Partial Dentures

ADA Code Description   Fee

D5213 Maxillary partial denture - cast metal frame $2400

D5214 Mandibular partial denture - cast metal frame $2400

D5510 Complete denture - maxillary $2335

D5520 Complete denture - mandibular $2335

(Prices valid 01/01/2024 - 12/31/2024)