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Summary of Discounts

Your membership in the Resolution Dental Plan provides you access to instant savings and up-front pricing
so you will know what to expect when it comes to your dental care needs. After enrolling in the plan, just show
your member ID at a participating dental office to take advantage of plan savings.

Summary of Discounts and Fees

ADA Code Diagnostic & Preventative Member Pays
D0120 Periodic oral Evaluation No Charge
D0140 Limited oral evaluation - problem focused No Charge
D0150 Comprehensive oral evaluation No Charge
D0210 X-Rays - complete set No Charge
D0220 Intraoral - first film No Charge
D0230 Intraoral - each additional film No Charge
D0272 Bitewings - two films No Charge
D0274 Bitewings - four films No Charge
D0330 Panoramic x-ray No Charge
D1110 Cleaning - adult $49
D1120 Cleaning - child $39
D1206 Topical application of fluoride varnish $19
D1208 Topical application of fluoride $19
D1351 Sealant - per tooth $29
Restorative - Fillings
Amalgam
D2140 One surface $89
D2150 Two surfaces $109
D2160 Three surfaces $129
Resin-based composite-anterior (front teeth)
D2330 One surface $99
D2331 Two surfaces $119
D2332 Three surfaces $149
D2335 Four surfaces $189
Resin-based composite-posterior (back teeth)
D2391 One surface $119
D2392 Two surfaces $149
D2393 Three surfaces $179
D2394 Four surfaces $199
Restorative - Crowns
D2740 Crown - porcelain/ceramic substrate $899
D2750 Crown - porcelain fused to high noble metal $799
D2751 Crown - porcelain fused to predominantly base metal $749
D2752 Crown - porcelain fused to noble metal $799
D2930 Prefabricated stainless steel crown - primary tooth $199
D2931 Prefabricated stainless steel crown - permanent tooth $199
D2934 Protective restoration $249
D2950 Core buildup (including pins) $179
D2954 Prefabricated post & core in addition to crown $219
Endodontics
D3220 Therapeutic pulpotomy (excluding final restoration) $119
D3310 Root canal - anterior $439
D3320 Root canal - bicuspid $599
D3330 Root canal - molar $799
Periodontics
D4341 Perio scaling & root planing - four or more teeth per quad $149
Prosthodontics - Removable
D5110 Complete denture - maxillary (upper) $999
D5120 Complete denture - mandibular (lower) $999
D5213 Partial denture - maxillary (upper) $1,099
D5214 Partial denture - mandibular (lower) $1,099
D5410 Adjust complete denture - (upper) $69
D5411 Adjust complete denture - (lower) $69
D5750 Reline complete maxillary denture (laboratory) $329
D5751 Reline complete mandibular denture (laboratory) $329
Oral Surgery - Extractions
D7111 Coronal remnants - deciduous tooth $89
D7140 Extraction, erupted tooth $109
D7210 Surgical removal of tooth $179
D7220 Impacted tooth - soft tissue $199
D7230 Impacted tooth - partial bony $249
D7240 Extraction - impacted tooth - full bony $299
Orthodontic Services
D8010-D8999 Orthodontic treatment $100 off Discounted pricing
Other Services
D9230 Inhalation of nitrous oxide/analgesia, anxiolysis $59
D9920 Behavior management $99
D9940 Occlusal night guard $399

Taking care of your oral health has never been easier!

Regular dental visits can contribute to a lifetime of oral health. Annual dental examinations and good oral hygiene can prevent most dental diseases. Don’t wait to see a dentist until you are in pain or think something is wrong. Resolution Dental Plan allows you to get the quality care you need at a price you can afford.

We love the Resolution Dental Plan!

I purchased the plan for my son and I. When my husband needed a tooth extraction, we decided to add him to the plan. Everything was so simple! We made his appointment, had the extraction, and paid the discounted fee, which we knew upfront. Now, we all can receive regular exams, x-rays, and cleanings at an affordable price. We love this hassle free plan.

I am relieved to have a Resolution membership!

As a single parent on a tight budget with two active teenagers, I need to be prepared for everything. Resolution gives me the confidence knowing that my kids can receive regular checkups and effective dental care at an affordable cost. I am always prepared if any unexpected dental expenses arise, not only for my kid’s, but myself too. Now that’s a relief!