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
In-Office Plan
We have our own in-office dental plan, which you may use only at our office. It does not cover referrals to specialists or other dental providers.
Basically our plan gives you the opportunity to pay for your cleaning exams and X-rays over a 6 month period each time you visit our office for your initial visit and then for when you visit us for your six-month follow up recall cleaning visit.
If you need to cancel, just call our office and give us 60 days advance notice. After the 60 day period, the plan will cancel on the renewal date. Each membership will auto-renew annually and you will be informed 45 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.
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 | $79 | $20 |
| D0170 | Re-evaluation Visit | $57 | $0 | $0 |
| 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 | $121 | $96 | $25 |
| D0350 | Diagnostic Photographs | $58 | $46 | $12 |
| D0351 | 3D Intra-oral Pix | $58 | $46 | $12 |
| D0367 | CBCT X-ray | $247 | $197 | $50 |
| D0460 | Pulp Test | $30 | $24 | $6 |
| D0470 | Diagnostic Casts | $66 | $52 | $14 |
| D0486 | Brush Biopsy Lab | $72 | $57 | $15 |
| D0601 | Caries Risk Low | $0 | $0 | $0 |
| D0602 | Caries Risk Moderate | $0 | $0 | $0 |
| D0603 | Caries Risk High | $0 | $0 | $0 |
PREVENTIVE SERVICES
| CODE | SERVICE | FEE | PLAN | Save |
| D1110 | Prophylaxis, adult | $92 | $0 | $92 |
| D1120 | Prophylaxis, child | $63 | $0 | $63 |
| D1206 | Topical fluoride varnish | $49 | $36 | $13 |
| D1208 | Topical application of fluoride | $33 | $0 | $33 |
| D1351 | Sealants per tooth to age 14 | $53 | $35 | $18 |
| D1355 | Silver Diamine Treatment per tooth | $33 | $26 | $7 |
| D1510 | Space maintainer, fixed, unilateral | $317 | $253 | $64 |
RESTORATIVE SERVICES
| CODE | SERVICE |
FEE |
PLAN |
SAVE |
| D2140 | Alloy 1 Surface | $131 | $104 | $27 |
| D2150 | Alloy 2 Surface | $169 | $135 | $34 |
| D2160 | Alloy 3 Surface | $204 | $163 | $42 |
| D2330 | Resin-based composite, 1 surface, anterior | $175 | $135 | $40 |
| D2331 | Resin-based composite, 2 surfaces, anterior | $202 | $161 | $41 |
| D2332 | Resin-based composite, 3 surfaces, anterior | $237 | $159 | $78 |
| D2335 | Resin-based composite, 4 or more surface anterior | $280 | $224 | $56 |
|
D2390 |
Resin Crown, anterior |
$311 | $248 | $63 |
| D2391 | Resin-based composite, 1 surface, posterior | $178 | $142 | $36 |
| D2392 | Resin-based composite, 2 surfaces, posterior | $233 | $186 | $47 |
| D2393 | Resin-based composite, 3 surfaces, posterior | $289 | $231 | $58 |
| D2394 | Resin-based composite, 4 or more surface posterior | $289 | $231 | $58 |
|
2610 |
Porcelain Inlay 1 surface, posterior |
$875 | $700 | $175 |
|
2620 |
Porcelain Inlay 2 surface, posterior |
$1000 | $800 | $200 |
|
2630 |
Porcelain Inlay 1 surface, posterior |
$1125 | $900 | $225 |
| D2740 | Crown, porcelain/ceramic substrate | $1142 | $850 | $292 |
| D2752 | Crown, porcelain fused to base metal | $1049 | $850 | $199 |
| D2790 | Crown, full cast high noble metal | $1087 | $850 | $237 |
| D2792 | Crown, full cast predominantly base metal | $1030 | $850 | $180 |
| D2920 | Recement crown | $99 | $79 | $20 |
|
D2929 |
Porcelain Primary crown |
$375 | $300 | $75 |
| D2930 | Prefabricated stainless steel crown, primary tooth | $271 | $216 | $55 |
| D2950 | Core buildup, including any pins | $258 | $206 | $52 |
| D2951 | Pin retention, per tooth | $58 | $46 | $12 |
| D2954 | Prefabricated post and core in add to crown | $326 | $260 | $66 |
|
2960 |
Labial Veneer, direct |
$789 | $631 | $158 |
| D2962 | Porcelain Veneer, lab | $972 | $850 | $122 |
ENDODONTIC SERVICES
| CODE |
SERVICE | FEE | PLAN | SAVE |
| D3110 | Direct Pulp Cap | $93 | $74 | $19 |
| D3220 | Theraputic, pulpotomy exclusive of final restoration | $190 | $152 | $38 |
| D3221 | Pulpal debridement, primary and permanent | $208 | $166 | $42 |
| D3222 | Partial pulpotomy for apexogenesis | $193 | $154 | $39 |
| D3310 | Root canal therapy – anterior | $726 | $580 | $146 |
| D3320 | Root canal therapy – bicuspid | $890 | $712 | $178 |
| D3330 | Root canal therapy – molar | $1104 | $883 | $221 |
|
D3332 |
Inoperative Endo |
$500 | $400 | $100 |
|
D3410 |
Apicoectomy, anterior |
$754 | $603 | $151 |
PERIODONTAL SERVICES
107
| CODE | SERVICE | FEE | PLAN | SAVE |
| D4210 | Gingivectomy or gingivoplasty, 4+ teeth | 517 | $413 | $104 |
| D4212 | G for Restorative | $230 | $184 | $46 |
| D4230 | A CR Exposure | $354 | $283 | $71 |
| D4240 | Gingival flap proc, including root planing, 4+ | $655 | $524 | $131 |
| D4249 | Clinical crown lengthening, hard tissue | $718 | $574 | $144 |
|
D4263 |
Periodontal Graft |
$391 | $312 | $79 |
|
D4266 |
Guided Tissue Regeneration |
$402 | $321 | $81 |
|
D4323 |
Teeth Splinting |
$350 | $280 | $70 |
|
D4341 |
Deep Cleaning, per quadrant |
$231 | $184 | $47 |
|
D4342 |
Deep Cleaning, per quadrant, 1-3 teeth |
$134 | $107 | $27 |
|
D4346 |
Periodontal Cleaning |
$86 | $68 | $20 |
|
D4355 |
Full Mouth Debridement |
$158 | $126 | $32 |
|
D4910 |
Periodontal Maintenance |
$142 | $113 | $29 |
|
D4921 |
Gingival Irrigation, quadrant |
$20 | $16 | $4 |
REMOVABLE PROSTHETIC SERVICES
$278$
| CODE | SERVICE | FEE | PLAN | SAVE |
| D5110 | Complete denture, maxillary | $1311 | $1048 | $263 |
| D5120 | Complete denture, mandibular | $1311 | $1048 | $263 |
| D5130 | Immediate denture, maxillary | $1430 | $1144 | $286 |
| D5140 | Immediate denture, mandibular | $1430 | $1144 | $286 |
| D5211 | Maxillary partial denture-resin base | $1107 | $1028 | $79 |
| D5212 | Mandibular partial denture-resin base | $1286 | $1028 | $257 |
| D5213 | Maxillary partial denture-cast metal framework | $1449 | $1159 | $290 |
| D5214 | Mandibular partial denture-cast metal framework | $1449 | $1159 | $290 |
| D5225 | Maxillary partial denture flexible base | $1107 | $887 | $220 |
| D5226 | Mandibular partial denture flexible base | $1286 | $1028 | $258 |
|
D5511 |
Repair Lower Denture |
$133 | $106 | $27 |
|
D5512 |
Repair Upper Denture |
$133 | $106 | $27 |
|
D5640 |
Replace Tooth |
$132 | $105 | $27 |
|
D5730 |
Reline Upper Denture |
$300 | $240 | $60 |
|
D5731 |
Reline Lower Denture |
$300 | $240 | $60 |
|
D5750 |
Reline Upper Denture Lab |
$401 | $320 | $81 |
|
D5751 |
Reline Lower Denture Lab |
$401 | $320 | $81 |
|
D5862 |
Precision ATTACH |
$391 | $312 | $79 |
|
D5863 |
Upper Overdenture |
$1388 | $1110 | $278 |
|
D5865 |
Lower Overdenture |
$1388 | $1110 | $278 |
|
D5986 |
Fluoride Gel Tray |
$120 | $96 | $24 |
|
D5995 |
Perio Tray Upper |
$300 | $240 | $60 |
|
D5996 |
Perio Tray Lower |
$300 | $240 | $60 |
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 |
$1046 | $836 | $210 |
|
6242 |
Porcelain to Metal Bridge Pontic |
$1033 | $826 | $207 |
|
6245 |
Porcelain Bridge Pontic |
$1094 | $875 | $219 |
|
6740 |
Porcelain Bridge Retainer |
$1118 | $894 | $224 |
|
6752 |
Porcelain to Metal Bridge Retainer |
$1040 | $832 | $208 |
|
6792 |
Metal Bridge Retainer |
$1033 | $826 | $207 |
ORAL SURGERY SERVICES
| CODE | SERVICE | FEE | PLAN | SAVE |
| D7111 | Extract coronal remnants deciduous tooth | $115 | $92 | $23 |
| D7140 | Extraction, erupted tooth or exposed root | $153 | $122 | $31 |
| D7210 | Surgical removal of erupted tooth | $259 | $207 | $52 |
| D7220 | Removal of impacted tooth, soft tissue | $325 | $260 | $65 |
| D7230 | Removal of impacted tooth, partially bony | $433 | $346 | $87 |
| D7240 | Removal of impacted tooth, completely bony | $508 | $406 | $102 |
| D7288 | Brush biopsy | $145 | $116 | $29 |
|
D7880 |
TMJ Splint |
$688 | $688 | $0 |
|
D7921 |
PRP treatment |
$278 | $222 | $56 |
|
D7953 |
Extraction Graft |
$424 | $339 | $85 |
|
D7971 |
Operculectomy |
$187 | $149 | $38 |
ADJUNCTIVE SERVICES
| CODE | SERVICE | FEE | PLAN | SAVE |
| D9230 | Analgesia, anxiolysis, nitrous oxide | $71 | $56 | $15 |
| D9430 | Office Visit – No Other Procedures Performed | $50 | $45 | $5 |
| D9972 | Teeth Whitening – Office | $313 | $250 | $63 |
| D9975 | Teeth Whitening – Take Home Trays | $313 | $250 | $63 |