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EYE
BENEFITS.
Your Appleton Dental
Plan membership also includes the EyeBenefits discount vision
benefit program whose provider network consists of over 10,000
optical store locations nationwide.

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CHECK OUT YOUR SAVINGS WITH APPLETON DENTAL PLAN
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ADA
Code
|
Procedure
|
Usual Fee |
Member
Fee |
Member
Savings |
|
0120 |
Routine 6 Month Check Up |
$ 43 |
$ 15 |
$ 28 |
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0210 |
Full Mouth X-rays |
$103 |
$ 25 |
$ 78 |
|
0274 |
Bitewings – four |
$ 55 |
$ 20 |
$ 35 |
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0330 |
Panoramic Film |
$ 90 |
$ 30 |
$ 60 |
|
1110 |
Adult Cleaning |
$ 77 |
$ 35 |
$ 42 |
|
1120 |
Child Cleaning |
$ 55 |
$ 30 |
$ 25 |
|
2140 |
Amalgam 1 surface
(silver filling) |
$139 |
$ 56 |
$ 83 |
|
2330 |
Composite 1 surface
(white filling) |
$123 |
$ 63 |
$ 60 |
|
2750 |
Crown porcelain high
noble |
$889 |
$595 |
$294 |
|
2950 |
Core buildup, including
pins |
$234 |
$120 |
$114 |
|
2952 |
Cast post & core in
addition to crown |
$403 |
$155 |
$248 |
|
3310 |
Root canal – anterior |
$582 |
$385 |
$197 |
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3320 |
Root canal – bicuspid |
$654 |
$450 |
$204 |
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3330 |
Root canal – molar |
$808 |
$595 |
$213 |
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4341 |
Periodontal scaling/root planing |
$204 |
$110 |
$ 94 |
|
7140 |
Extraction, erupted
tooth or exposed root |
$166 |
$ 95 |
$ 71 |
To explore Appleton Dental
Plan's Fee Schedule further, you may review the entire
document in PDF format
here. (54Kb download)
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CHOOSE A PLAN,
START SAVING.
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General Plan
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Annual
Cost
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Individual |
$60.00 |
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Individual
Plus One |
$80.00 |
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Family |
$120.00 |
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Group
Plan
|
Monthly Cost
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Under
50 |
Over
50 |
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Individual |
$6.50 |
$5.00 |
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Individual
Plus One |
$8.75 |
$6.67 |
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Family |
$13.50 |
$10.00 |
Sign up for membership
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OUR COMMITMENT
TO YOU
It is our intention that you
find your association with us professional, successful and beneficial; and
we will do all in our power to see that you are satisfied at all times with
Appleton Dental Plan. Our members are our greatest asset, and we value
your participation in our Plan! Please feel free to contact the
Appleton Dental Plan management and staff at any time with questions or
comments.
Appleton Dental Plan
7337 E. Shoeman Lane
Scottsdale, AZ
85251
Toll-Free
866.576.4531
Phoenix Area
602.957.6453
Fax 480.941.4390
Office Hours:
Monday through
Friday
8:30am - 5pm.
Disclaimer
Privacy Policy
Terms &
Conditions |
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