What your dental bill actually says

How to read a dental estimate

An estimate is a list of codes with fees beside them. The codes are what your dentist sends to your insurer, and they are what the insurer pays against — so the specific code chosen decides both what the treatment is recorded as and how much of it is covered.

Three things cause nearly all of the confusion. First, codes that sound almost identical carry very different fees: the difference between a two-surface and a three-surface filling, or between a crown in one alloy and the same crown in another, is a few words in the description and several hundred dollars on the bill.

Second, a single appointment usually produces several codes. An examination, a set of X-rays and a cleaning are three separate procedures with three separate frequency limits, which is why they are billed separately rather than bundled.

Third, a plan can cover a procedure and still not pay for the version you are having. Alternate-benefit clauses pay the allowance for the cheaper material and leave you the difference — the reason a white filling on a back tooth, or a ceramic crown on a molar, so often arrives with a balance attached.

Every code page here covers those three points for that code specifically: what it requires, what it costs, what your plan is likely to do with it, and which neighbouring code it gets mistaken for.