In-Office Plan
We have our own in-office dental savings plan, which you may use only at our office. It does not cover referrals to specialists or other dental providers.
Basically our plan covers two dental exams and routine dental X-rays per person during the year enrolled. Cleanings and periodontal therapy are not free, but are included at a discounted rate. See the Summary of Discounts page to see what your fees will be and how much they differ from our regular fees.
Please note that this is not dental insurance, but is a dental savings plan valid only at our office. It does not cover specialist fees, orthodontic treatment or implant services.
Also note that one emergency exam is included in the plan and any teeth in one quadrant will be diagnosed and an estimate given free of charge.
Full mouth estimates are quite involved sometimes and require a dental cleaning, at the membership rate, to expose all areas of decay on your teeth.
If you need to cancel, just call our office and cancel anytime. Each membership will auto-renew annually and you will be informed 30 days ahead of time for this, if you would prefer to opt-out of your membership.
Fees and membership payments are subject to revision annually and may be subject to change or cancellation. Plan membership does not obligate you to have your dental treatment done here.
If you would like to purchase a membership and have dental insurance, this is allowed however since X-rays and exam charges are covered by insurance, you will not be charged for these services, but they will be billed to your carrier. The reduced plan fees will be used for billing purposes with your insurance, so this is the main advantage of plan enrollment. If you are on a PPO plan, we are obligated to follow your PPO plan fees, so the only real benefit would be to have coverage for a family member who is not included in your dental coverage.
Payment Options
Miles Dental Plan offers our patients a number of payment options to choose from. Insurance or no insurance, we’ve got you covered!
Billing or insurance questions? Please email us at office@milesdental.com for the quickest response.
Our office accepts Visa, Master Card, Discover. Cash, personal checks, and money orders are also accepted.
Payment is required at the time of service.
In order to keep our costs to our patients minimal, we do not offer in-office financing. However, we do accept third-party healthcare financing that offers zero percent interest plans:
Care Credit: Applications are easy and many people are eligible even with bad credit. Click here for the Care Credit website.
Signing up and eligibility verification is easy! Our staff can assist you with the application process as well.
Insurance
Below is a list of common dental services
and what you’ll pay with Miles Dental Plan

DIAGNOSTIC SERVICES
CODE | SERVICE | FEE | PLAN | SAVE |
D0120 | Periodic oral evaluation | $49 | $0 | $49 |
D0140 | Limited oral evaluation, problem focused | $82 | $0 | $82 |
D0145 | Exam patient under 3 years include counsel | $76 | $0 | $76 |
D0150 | Comprehensive oral evaluation | $86 | $0 | $86 |
D0160 | Extensive Exam | $99 | $0 | $20 |
D0170 | Re-evaluation Visit | $57 | $0 | $57 |
D0180 | Comprehensive periodontal evaluation | $93 | $0 | $93 |
D0210 | Intraoral complete series (including bitewings) | $130 | $0 | $130 |
D0220 | Intraoral periapical, first film | $26 | $0 | $26 |
D0230 | Intraoral periapical, each additional film | $23 | $0 | $23 |
D0272 | Bitewings, two films | $44 | $0 | $44 |
D0274 | Bitewing, four films | $62 | $0 | $62 |
D0330 | Panoramic film | $108 | $0 | $108 |
D0340 | Cephalometric film | $128 | $96 | $32 |
D0350 | Diagnostic Photographs | $58 | $46 | $12 |
D0351 | 3D Intra-oral Pix | $61 | $46 | $18 |
D0367 | CBCT X-ray | $262 | $197 | $65 |
D0460 | Pulp Test | $32 | $24 | $8 |
D0470 | Diagnostic Casts | $69 | $52 | $17 |
D0486 | Brush Biopsy Lab | $76 | $57 | $19 |

PREVENTIVE SERVICES
CODE | SERVICE | FEE | PLAN | Save |
D1110 | Prophylaxis, adult | $131 | $99 | $32 |
D1120 | Prophylaxis, child | $83 | $63 | $20 |
D1206 | Topical fluoride varnish | $48 | $36 | $12 |
D1208 | Topical application of fluoride | $33 | $0 | $33 |
D1351 | Sealants per tooth to age 14 | $66 | $50 | $16 |
D1355 | Silver Diamine Treatment per arch | $53 | $40 | $13 |
D1510 | Space maintainer, fixed, unilateral | $336 | $253 | $83 |

RESTORATIVE SERVICES
CODE | SERVICE |
FEE |
PLAN |
SAVE |
D2330 | Resin-based composite, 1 surface, anterior | $202 | $152 | $50 |
D2331 | Resin-based composite, 2 surfaces, anterior | $258 | $194 | $64 |
D2332 | Resin-based composite, 3 surfaces, anterior | $315 | $237 | $78 |
D2335 | Resin-based composite, 4 or more surface anterior | $372 | $280 | $92 |
D2390 | Resin Crown, anterior | $413 | $311 | $102 |
D2391 | Resin-based composite, 1 surface, posterior | $236 | $178 | $59 |
D2392 | Resin-based composite, 2 surfaces, posterior | $310 | $233 | $77 |
D2393 | Resin-based composite, 3 surfaces, posterior | $384 | $289 | $95 |
D2394 | Resin-based composite, 4 or more surface posterior | $471 | $354 | $117 |
2610 | Porcelain Inlay 1 surface, posterior | $1347 | $1013 | $334 |
2620 | Porcelain Inlay 2 surface, posterior | $1421 | $1069 | $352 |
2630 | Porcelain Inlay 1 surface, posterior | $1514 | $1139 | $445 |
D2740 | Crown, porcelain/ceramic substrate | $1397 | $1050 | $346 |
D2752 | Crown, porcelain fused to base metal | $1330 | $1000 | $330 |
D2790 | Crown, full cast high noble metal | $1446 | $1087 | $359 |
D2792 | Crown, full cast predominantly base metal | $1330 | $1000 | $330 |
D2920 | Recement crown | $132 | $99 | $33 |
D2929 | Porcelain Primary crown | $523 | $393 | $130 |
D2930 | Prefabricated stainless steel crown, primary tooth | $497 | $374 | $123 |
D2950 | Core buildup, including any pins | $343 | $258 | $85 |
D2951 | Pin retention, per tooth | $77 | $58 | $19 |
D2954 | Prefabricated post and core in add to crown | $459 | $326 | $133 |
2960 | Labial Veneer, direct | $1190 | $895 | $295 |
D2962 | Porcelain Veneer, lab | $1292 | $972 | $321 |

ENDODONTIC SERVICES
CODE |
SERVICE | FEE | PLAN | SAVE |
D3110 | Direct Pulp Cap | $124 | $93 | $31 |
D3220 | Theraputic, pulpotomy exclusive of final restoration | $253 | $190 | $63 |
D3221 | Pulpal debridement, primary and permanent | $277 | $208 | $69 |
D3222 | Partial pulpotomy for apexogenesis | $257 | $193 | $64 |
D3310 | Root canal therapy – anterior | $965 | $726 | $239 |
D3320 | Root canal therapy – bicuspid | $1184 | $890 | $293 |
D3330 | Root canal therapy – molar | $1323 | $995 | $328 |
D3332 | Inoperative Endo | $719 | $541 | $178 |
D3410 | Apicoectomy, anterior | $1002 | $754 | $248 |

PERIODONTAL SERVICES
CODE | SERVICE | FEE | PLAN | SAVE |
D4210 | Gingivectomy per quadrant | 687 | $517 | $171 |
D4212 | Gingivectomy per one to three teeth | $244 | $184 | $61 |
D4230 | Anotomical Crown Exposure | $459 | $345 | $114 |
D4240 | Gingival flap proc, including root planing, per quadrant | $871 | $655 | $216 |
D4249 | Clinical crown lengthening, hard tissue | $955 | $718 | $237 |
D4263 | Periodontal Graft | $520 | $391 | $129 |
D4266 | Guided Tissue Regeneration | $534 | $402 | $132 |
D4323 | Teeth Splinting | $484 | $364 | $120 |
D4341 | Deep Cleaning, per quadrant | $266 | $200 | $66 |
D4342 | Deep Cleaning, per quadrant, 1-3 teeth | $160 | $120 | $40 |
D4346 | Periodontal Scaling | $266 | $200 | $66 |
D4910 | Periodontal Maintenance | $189 | $142 | $47 |
D4921 | Gingival Irrigation, per arch | $21 | $16 | $5 |
D4355 | Full Mouth Debridement | $200 | $150 | $50 |

REMOVABLE PROSTHETIC SERVICES
CODE | SERVICE | FEE | PLAN | SAVE |
D5110 | Complete denture, maxillary | $1743 | $1311 | $432 |
D5120 | Complete denture, mandibular | $1743 | $1311 | $432 |
D5130 | Immediate denture, maxillary | $1901 | $1430 | $471 |
D5140 | Immediate denture, mandibular | $1901 | $1430 | $471 |
D5211 | Maxillary partial denture-resin base | $1472 | $1107 | $365 |
D5212 | Mandibular partial denture-resin base | $1710 | $1286 | $424 |
D5213 | Maxillary partial denture-cast metal framework | $1927 | $1449 | $478 |
D5214 | Mandibular partial denture-cast metal framework | $1927 | $1449 | $478 |
D5225 | Maxillary partial denture flexible base | $1472 | $1107 | $365 |
D5226 | Mandibular partial denture flexible base | $1710 | $1286 | $424 |
D5511 | Repair Lower Denture – replace broken or missing teeth | $200 | $150 | $50 |
D5512 | Repair Upper Denture – replace broken or missing teeth | $159 | $120 | $40 |
D5640 | Replace Tooth | $176 | $132 | $44 |
D5730 | Reline Upper Denture | $400 | $300 | $100 |
D5731 | Reline Lower Denture | $400 | $300 | $100 |
D5750 | Reline Upper Denture Lab | $533 | $401 | $132 |
D5751 | Reline Lower Denture Lab | $533 | $401 | $132 |
D5862 | Precision ATTACH | $465 | $350 | $115 |
D5863 | Upper Overdenture | $1846 | $1388 | $458 |
D5865 | Lower Overdenture | $2435 | $1831 | $604 |
D5986 | Fluoride Gel Tray | $160 | $120 | $40 |
D5995 | Perio Tray Upper | $425 | $350 | $75 |
D5996 | Perio Tray Lower | $425 | $350 | $75 |

IMPLANT SERVICES
CODE | SERVICE | FEE | PLAN | SAVE |
D6010 | Surgical placement: endosteal implant | $2101 | $2101 | $0 |
D6011 | Healing Cap | $100 | $100 | $0 |
D6013 | Mini Implant | $2191 | $2191 | $0 |
D6055 |
Implant Bar |
$658 | $658 | $0 |
D6056 |
Prefabricated Abutment |
$455 | $455 | $0 |
D6057 |
Custom Abutment |
$562 | $562 | $0 |
D6058 |
Porcelain Implant Crown |
$1261 | $1261 | $0 |
D6059 |
Porcelain to Metal Implant Crown |
$1244 | $1244 | $0 |
D6065 |
Direct Implant Crown |
$1241 | $1241 | $0 |
D6104 |
Implant Bone Graft |
$407 | $407 | $0 |
D6191 |
Implant Precision Attachment |
$385 | $385 | $0 |

FIXED PROSTHETIC SERVICES
CODE | SERVICE | FEE | PLAN | SAVE |
6212 | Metal Bridge Pontic | $1130 | $850 | $280 |
6242 | Porcelain to Metal Bridge Pontic | $1197 | $900 | $297 |
6245 | Porcelain Bridge Pontic | $1197 | $900 | $297 |
6740 | Porcelain Bridge Retainer | $1330 | $1000 | $133 |
6752 | Porcelain to Metal Bridge Retainer | $1330 | $1000 | $133 |
6792 | Metal Bridge Retainer | $1130 | $850 | $280 |

ORAL SURGERY SERVICES
CODE | SERVICE | FEE | PLAN | SAVE |
D7111 | Extract coronal remnants deciduous tooth | $153 | $115 | $38 |
D7140 | Extraction, erupted tooth or exposed root | $204 | $153 | $50 |
D7210 | Surgical removal of erupted tooth | $344 | $259 | $85 |
D7220 | Removal of impacted tooth, soft tissue | $432 | $325 | $107 |
D7230 | Removal of impacted tooth, partially bony | $576 | $433 | $143 |
D7240 | Removal of impacted tooth, completely bony | $675 | $508 | $167 |
D7288 | Brush biopsy | $193 | $145 | $48 |
D7880 | TMJ Splint | $915 | $688 | $227 |
D7921 | PRP treatment | $295 | $222 | $73 |
D7953 | Socket Dressing | $20 | $0 | $20 |
D7953 | Extraction Graft | $299 | $225 | $70 |
D7971 | Operculectomy | $248 | $187 | $62 |

ADJUNCTIVE SERVICES
CODE | SERVICE | FEE | PLAN | SAVE |
D9230 | Analgesia, anxiolysis, nitrous oxide | $100 | $75 | $25 |
D9430 | Office Visit – No Other Procedures Performed | $60 | $45 | $15 |
D9972 | Teeth Whitening – Office | $365 | $275 | $91 |
D9975 | Teeth Whitening – Take Home Trays | $318 | $239 | $79 |
D9987 | Broken Appointment Deposit | $50 | $50 | $0 |