Making Dentistry Affordable for Everyone is What We Do
Epic Dental Plan provides transparent pricing so plan members know exactly what to expect when it comes to their dental care needs. Plan members receive member-only 20-50% SAVINGS on all dental procedures including preventive, basic, major, cosmetic, and even orthodontics!
Epic Dental Plan keeps it simple and features no waiting periods, exclusions or maximums.
| Diagnostic And Preventive | ||||
| Code | Description | Retail Fee* | Member Pays | Member Savings* |
| D0120 | Periodic Exam | $48.00 | $24.00 | 50% |
| D0140 | Limited Exam – Problem Focused | $50.00 | $25.00 | 50% |
| D0150 | Comprehensive Exam | $50.00 | $25.00 | 50% |
| D0210 | X-rays - Complete Series | $100.00 | $50.00 | 50% |
| D0220 | Intraoral X-Ray (First Film) | $25.00 | $13.00 | 50% |
| D0274 | Bitewings – Four Films | $50.00 | $25.00 | 50% |
| D0330 | Panoramic Film | $143.00 | $72.00 | 50% |
| D1110 | Adult Cleaning - Age 14+ | $75.00 | $38.00 | 50% |
| D1120 | Child Cleaning - Under Age 14 | $50.00 | $25.00 | 50% |
| D1208 | Fluoride | $42.00 | $21.00 | 50% |
| D1351 | Sealant – Per Tooth | $72.00 | $36.00 | 50% |
| Restorative - Amalgam Fillings | ||||
| Code | Description | Retail Fee* | Member Pays | Member Savings* |
| D2140 | One Surface | $118.00 | $89.00 | 25% |
| D2150 | Two Surfaces | $159.00 | $119.00 | 25% |
| D2160 | Three Surfaces | $169.00 | $127.00 | 25% |
| Restorative - Composite Fillings (Resin Based) | ||||
| Code | Description | Retail Fee* | Member Pays | Member Savings* |
| D2330 | One Surface, Anterior | $159.00 | $119.00 | 25% |
| D2331 | Two Surfaces, Anterior | $198.00 | $149.00 | 25% |
| D2332 | Three Surfaces, Anterior | $242.00 | $182.00 | 25% |
| D2335 | Four+ Surfaces, Anterior | $306.00 | $230.00 | 25% |
| D2391 | One Surface, Posterior | $171.00 | $128.00 | 25% |
| D2392 | Two Surfaces, Posterior | $247.00 | $185.00 | 25% |
| D2393 | Three Surfaces, Posterior | $297.00 | $223.00 | 25% |
| Crowns | ||||
| Code | Description | Retail Fee* | Member Pays | Member Savings* |
| D2740 | Crown - Porcelain/Ceramic | $1,482.00 | $1,112.00 | 25% |
| D2750 | Crown – Porcelain/High Noble Metal | $1,433.00 | $1,075.00 | 25% |
| D2751 | Crown – Porcelain/Base Metal | $1,231.00 | $923.00 | 25% |
| D2752 | Crown – Porcelain/Noble Metal | $1,335.00 | $1,001.00 | 25% |
| D2950 | Core Build-Up, Including Pins | $373.00 | $280.00 | 25% |
| D2952 | Post And Core In Addition To Crown, Indirectly Fabricated | $472.00 | $354.00 | 25% |
| Root Canals | ||||
| Code | Description | Retail Fee* | Member Pays | Member Savings* |
| D3310 | Anterior Root Canal (Excluding Final Restoration) | $794.00 | $596.00 | 25% |
| D3320 | Bicuspid Root Canal (Excluding Final Restoration) | $1,007.00 | $755.00 | 25% |
| D3330 | Molar Root Canal (Exclusing Final Restoration) | $1,251.00 | $938.00 | 25% |
| Periodontics | ||||
| Code | Description | Retail Fee* | Member Pays | Member Savings* |
| D4341 | Scaling/Root Planing - 4+ Teeth Per Quad | $262.00 | $197.00 | 25% |
| D4342 | Scaling/Root Planing - 1-3 Teeth Per Quad | $154.00 | $116.00 | 25% |
| D4381 | Arestin | $68.00 | $51.00 | 25% |
| D4910 | Periodontal Maintenance | $156.00 | $117.00 | 25% |
| Dentures | ||||
| Code | Description | Retail Fee* | Member Pays | Member Savings* |
| D5110 | Complete Denture – Upper | $1,504.00 | $1,128.00 | 25% |
| D5120 | Complete Denture – Lower | $1,453.00 | $1,090.00 | 25% |
| D5510 | Repair Broken Denture Base | $196.00 | $147.00 | 25% |
| D5730 | Reline Upper Denture (Chairside) | $333.00 | $250.00 | 25% |
| D5731 | Reline complete mandibular denture (chariside) | $333.00 | $250.00 | 25% |
| D5740 | Reline maxillary partial denture (chairside) | $333.00 | $250.00 | 25% |
| D5741 | Reline mandibular partial denture (Chairside) | $333.00 | $250.00 | 25% |
| D5750 | Reline Upper Denture (Laboratory) | $451.00 | $338.00 | 25% |
| D5751 | Reline Lower Denture (Laboratory) | $451.00 | $338.00 | 25% |
| Bridges | ||||
| Code | Description | Retail Fee* | Member Pays | Member Savings* |
| D6010 | Surg Place Implant - Endosteal | $2,458.00 | $1,844.00 | 25% |
| D6057 | Cust Abutment -Incl Placement | $896.00 | $672.00 | 25% |
| D6058 | Implant - Porcelain | $1,566.00 | $1,175.00 | 25% |
| D6060 | Abtmt Supp Porc Fused - Base Metal | $1,409.00 | $1,057.00 | 25% |
| D6750 | Crown – Porcelain/High Noble Metal | $1,281.00 | $961.00 | 25% |
| D6751 | Crown – Porcelain/Base Metal | $1,231.00 | $923.00 | 25% |
| D6752 | Crown – Porcelain/Noble Metal | $1,292.00 | $969.00 | 25% |
| Extractions | ||||
| Code | Description | Retail Fee* | Member Pays | Member Savings* |
| D7140 | Simple Extraction | $159.00 | $119.00 | 25% |
Massachusetts | New Hampshire | Texas
*Member Savings is the amount the member pays less their affiliated provider's Retail Fee. The Retail Fee refers to the normal rate charged to uninsured patients for services rendered by the provider. Retail Fees and Member Savings can vary by affiliated provider. Plan savings and incentives are not available to patients whose dental care is covered by Medicaid.
“Epic Dental Plan is great for our family. We've always paid out-of-pocket for dentistry, but now receive significant and transparent 20-50% member-only savings on all our dental care needs at our affiliated dental provider's office." - Reagan
"Our employer offered dental insurance was expensive and lacked value. We needed a dental plan that is affordable, easy-to-use, and has significant real dollar savings. For only about $7.50/month, Epic Dental Plan saves us hundreds of dollars each time we visit our dentist!" - Charlie & Mallory