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Careington Dental

Dental Schedule

Quotes & Purchase

Dental schedule by state

Choose your state from the selection on the right.

Dental Schedule

Choose your state from the selection above

Schedule of Services

  • This sample schedule is an abbreviated list taken from the full Careington Care 500 fee schedule and applies to services provided by a participating general dentist. The purpose of this schedule is to establish the maximum fee that a general dentist will charge for each listed procedure. Participant is responsible for full payment of all charges at the time of service.
  • Your participating provider will have a complete fee schedule, or you may request one by calling us.
  • Participating Specialists (Board Certified or Advanced Degree) do not charge according to a fee schedule. Participating Specialists will give a 20% discount off of their normal fees.
  • Discount plans are not insurance.
Careington Care 500 Member Schedule - 501
Diagnostic ServicesMember Pays
D0120Periodic oral evaluation - established patient$16
D0150Comprehensive oral evaluation - new or established patient$21
D0270Bitewing - single radiographic image$12
D0272Bitewings - two radiographic images$15
D0273Bitewings - three radiographic images$20
D0274Bitewings - four radiographic images$24
Preventive ServicesMember Pays
D1110Prophylaxis - adult$34
D1120Prophylaxis - child$25
Restorative ServicesMember Pays
D2330Resin-based composite - one surface, anterior$60
D2391Resin-based composite - one surface, posterior$75
D2750Crown - porcelain fused to high noble metal$557
D2790Crown - full cast high noble metal$547
Endodontic ServicesMember Pays
D3310Endodontic therapy, anterior tooth (excluding final restoration)$320
D3330Endodontic therapy, molar tooth (excluding final restoration)$477
Periodontic ServicesMember Pays
D4341Periodontal scaling and root planing - four or more teeth per quadrant$111
D4910Periodontal maintenance$71
Prosthodontic Services (removable)Member Pays
D5110Complete denture - maxillary$701
D5120Complete denture - mandibular$701
D5213Maxillary partial denture - cast metal framework with resin denture bases (including retentive/clasping materials, rests and teeth)$795
D5214Mandibular partial denture - cast metal framework with resin denture bases (including retentive/clasping materials, rests and teeth)$795
D5750Reline complete maxillary denture (indirect)$194
D5751Reline complete mandibular denture (indirect)$194
Oral Surgery ServicesMember Pays
D7140Extraction, erupted tooth or exposed root (elevation and/or forceps removal)$60
Adjunctive ServicesMember Pays
D9215Local anesthesia in conjunction with operative or surgical procedures$14
D9230Inhalation of nitrous oxide/analgesia, anxiolysis$28

Exclusions and Limitations

  1. Fees subject to change.
  2. The dollar amount specified adjacent to each procedure may not be the only cost incurred for a given treatment - many treatments may require more than one dental procedure. Please consult your provider for a detailed treatment plan prior to beginning any work.
  3. The administrator can not guarantee the continued participation of any dentist. If the dentist leaves the plan, you will need to select another participating provider. Not all types of dentists may be available in your area.
  4. It is the member’s responsibility to verify that the dentist is a participating provider before seeking any treatment. Any dental procedures performed by a nonparticipating dentist are not discounted and are charged at the dentist's normal fees.
  5. While all participating Careington providers are professionally licensed in the state in which they practice, Careington does not guarantee the quality of service of the providers. Any quality of care concerns involving any participating Careington provider should be directed in writing to: Careington International Corporation, Attn. Provider Relations, PO Box 2568, Frisco, Texas 75034.
DISCLAIMER:THIS PLAN IS NOT INSURANCE and is not intended to replace health insurance. This plan does not meet the minimum creditable coverage requirements under M.G.L. c.111M and 956 CMR 5.00. This plan is not a Qualified Health Plan under the Affordable Care Act. The range of discounts will vary depending on the type of provider and service. The plan does not pay providers directly. Plan members must pay for all services but will receive a discount from participating providers. The list of participating providers is on this page . A written list of participating providers is available upon request. You may cancel within the first 30 days after effective date or receipt of membership materials (whichever is later) and receive a full refund, less a nominal processing fee (nominal fee for MD residents is $5, AR and TN residents will be refunded processing fee). Discount Plan Organization and administrator: Careington International Corporation, 7400 Gaylord Parkway, Frisco, TX 75034.

This plan is not available in Vermont or Washington.

Effective January 1, 2023

Member Sample Schedule: 501 (2023 CDT Compliant)

Schedule of Services

  • This sample schedule is an abbreviated list taken from the full Careington Care 500 fee schedule and applies to services provided by a participating general dentist. The purpose of this schedule is to establish the maximum fee that a general dentist will charge for each listed procedure. Participant is responsible for full payment of all charges at the time of service.
  • Your participating provider will have a complete fee schedule, or you may request one by calling us.
  • Participating Specialists (Board Certified or Advanced Degree) do not charge according to a fee schedule. Participating Specialists will give a 20% discount off of their normal fees.
  • Discount plans are not insurance.
Careington Care 500 Member Schedule - 502
Diagnostic ServicesMember Pays
D0120Periodic oral evaluation - established patient$17
D0150Comprehensive oral evaluation - new or established patient$28
D0270Bitewing - single radiographic image$13
D0272Bitewings - two radiographic images$16
D0273Bitewings - three radiographic images$23
D0274Bitewings - four radiographic images$27
Preventive ServicesMember Pays
D1110Prophylaxis - adult$40
D1120Prophylaxis - child$28
Restorative ServicesMember Pays
D2330Resin-based composite - one surface, anterior$65
D2391Resin-based composite - one surface, posterior$88
D2750Crown - porcelain fused to high noble metal$630
D2790Crown - full cast high noble metal$620
Endodontic ServicesMember Pays
D3310Endodontic therapy, anterior tooth (excluding final restoration)$363
D3330Endodontic therapy, molar tooth (excluding final restoration)$541
Periodontic ServicesMember Pays
D4341Periodontal scaling and root planing - four or more teeth per quadrant$122
D4910Periodontal maintenance$75
Prosthodontic Services (removable)Member Pays
D5110Complete denture - maxillary$791
D5120Complete denture - mandibular$791
D5213Maxillary partial denture - cast metal framework with resin denture bases (including retentive/clasping materials, rests and teeth)$897
D5214Mandibular partial denture - cast metal framework with resin denture bases (including retentive/clasping materials, rests and teeth)$897
D5750Reline complete maxillary denture (indirect)$219
D5751Reline complete mandibular denture (indirect)$219
Oral Surgery ServicesMember Pays
D7140Extraction, erupted tooth or exposed root (elevation and/or forceps removal)$65
Adjunctive ServicesMember Pays
D9215Local anesthesia in conjunction with operative or surgical procedures$16
D9230Inhalation of nitrous oxide/analgesia, anxiolysis$29

Exclusions and Limitations

  1. Fees subject to change.
  2. The dollar amount specified adjacent to each procedure may not be the only cost incurred for a given treatment - many treatments may require more than one dental procedure. Please consult your provider for a detailed treatment plan prior to beginning any work.
  3. The administrator can not guarantee the continued participation of any dentist. If the dentist leaves the plan, you will need to select another participating provider. Not all types of dentists may be available in your area.
  4. It is the member’s responsibility to verify that the dentist is a participating provider before seeking any treatment. Any dental procedures performed by a nonparticipating dentist are not discounted and are charged at the dentist's normal fees.
  5. While all participating Careington providers are professionally licensed in the state in which they practice, Careington does not guarantee the quality of service of the providers. Any quality of care concerns involving any participating Careington provider should be directed in writing to: Careington International Corporation, Attn. Provider Relations, PO Box 2568, Frisco, Texas 75034.
DISCLAIMER:THIS PLAN IS NOT INSURANCE and is not intended to replace health insurance. This plan does not meet the minimum creditable coverage requirements under M.G.L. c.111M and 956 CMR 5.00. This plan is not a Qualified Health Plan under the Affordable Care Act. The range of discounts will vary depending on the type of provider and service. The plan does not pay providers directly. Plan members must pay for all services but will receive a discount from participating providers. The list of participating providers is on this page . A written list of participating providers is available upon request. You may cancel within the first 30 days after effective date or receipt of membership materials (whichever is later) and receive a full refund, less a nominal processing fee (nominal fee for MD residents is $5, AR and TN residents will be refunded processing fee). Discount Plan Organization and administrator: Careington International Corporation, 7400 Gaylord Parkway, Frisco, TX 75034.

This plan is not available in Vermont or Washington.

Effective January 1, 2023

Member Sample Schedule: 502 (2023 CDT Compliant)

Schedule of Services

  • This sample schedule is an abbreviated list taken from the full Careington Care 500 fee schedule and applies to services provided by a participating general dentist. The purpose of this schedule is to establish the maximum fee that a general dentist will charge for each listed procedure. Participant is responsible for full payment of all charges at the time of service.
  • Your participating provider will have a complete fee schedule, or you may request one by calling us.
  • Participating Specialists (Board Certified or Advanced Degree) do not charge according to a fee schedule. Participating Specialists will give a 20% discount off of their normal fees.
  • Discount plans are not insurance.
Careington Care 500 Member Schedule - 503
Diagnostic ServicesMember Pays
D0120Periodic oral evaluation - established patient$19
D0150Comprehensive oral evaluation - new or established patient$24
D0270Bitewing - single radiographic image$13
D0272Bitewings - two radiographic images$17
D0273Bitewings - three radiographic images$24
D0274Bitewings - four radiographic images$28
Preventive ServicesMember Pays
D1110Prophylaxis - adult$41
D1120Prophylaxis - child$34
Restorative ServicesMember Pays
D2330Resin-based composite - one surface, anterior$72
D2391Resin-based composite - one surface, posterior$90
D2750Crown - porcelain fused to high noble metal$674
D2790Crown - full cast high noble metal$659
Endodontic ServicesMember Pays
D3310Endodontic therapy, anterior tooth (excluding final restoration)$384
D3330Endodontic therapy, molar tooth (excluding final restoration)$573
Periodontic ServicesMember Pays
D4341Periodontal scaling and root planing - four or more teeth per quadrant$136
D4910Periodontal maintenance$82
Prosthodontic Services (removable)Member Pays
D5110Complete denture - maxillary$826
D5120Complete denture - mandibular$826
D5213Maxillary partial denture - cast metal framework with resin denture bases (including retentive/clasping materials, rests and teeth)$937
D5214Mandibular partial denture - cast metal framework with resin denture bases (including retentive/clasping materials, rests and teeth)$937
D5750Reline complete maxillary denture (indirect)$232
D5751Reline complete mandibular denture (indirect)$232
Oral Surgery ServicesMember Pays
D7140Extraction, erupted tooth or exposed root (elevation and/or forceps removal)$72
Adjunctive ServicesMember Pays
D9215Local anesthesia in conjunction with operative or surgical procedures$17
D9230Inhalation of nitrous oxide/analgesia, anxiolysis$32

Exclusions and Limitations

  1. Fees subject to change.
  2. The dollar amount specified adjacent to each procedure may not be the only cost incurred for a given treatment - many treatments may require more than one dental procedure. Please consult your provider for a detailed treatment plan prior to beginning any work.
  3. The administrator can not guarantee the continued participation of any dentist. If the dentist leaves the plan, you will need to select another participating provider. Not all types of dentists may be available in your area.
  4. It is the member’s responsibility to verify that the dentist is a participating provider before seeking any treatment. Any dental procedures performed by a nonparticipating dentist are not discounted and are charged at the dentist's normal fees.
  5. While all participating Careington providers are professionally licensed in the state in which they practice, Careington does not guarantee the quality of service of the providers. Any quality of care concerns involving any participating Careington provider should be directed in writing to: Careington International Corporation, Attn. Provider Relations, PO Box 2568, Frisco, Texas 75034.
DISCLAIMER:THIS PLAN IS NOT INSURANCE and is not intended to replace health insurance. This plan does not meet the minimum creditable coverage requirements under M.G.L. c.111M and 956 CMR 5.00. This plan is not a Qualified Health Plan under the Affordable Care Act. The range of discounts will vary depending on the type of provider and service. The plan does not pay providers directly. Plan members must pay for all services but will receive a discount from participating providers. The list of participating providers is on this page . A written list of participating providers is available upon request. You may cancel within the first 30 days after effective date or receipt of membership materials (whichever is later) and receive a full refund, less a nominal processing fee (nominal fee for MD residents is $5, AR and TN residents will be refunded processing fee). Discount Plan Organization and administrator: Careington International Corporation, 7400 Gaylord Parkway, Frisco, TX 75034.

This plan is not available in Vermont or Washington.

Effective January 1, 2023

Member Sample Schedule: 503 (2023 CDT Compliant)

Schedule of Services

  • This sample schedule is an abbreviated list taken from the full Careington Care 500 fee schedule and applies to services provided by a participating general dentist. The purpose of this schedule is to establish the maximum fee that a general dentist will charge for each listed procedure. Participant is responsible for full payment of all charges at the time of service.
  • Your participating provider will have a complete fee schedule, or you may request one by calling us.
  • Participating Specialists (Board Certified or Advanced Degree) do not charge according to a fee schedule. Participating Specialists will give a 20% discount off of their normal fees.
  • Discount plans are not insurance.
Careington Care 500 Member Schedule - 504
Diagnostic ServicesMember Pays
D0120Periodic oral evaluation - established patient$20
D0150Comprehensive oral evaluation - new or established patient$25
D0270Bitewing - single radiographic image$14
D0272Bitewings - two radiographic images$19
D0273Bitewings - three radiographic images$25
D0274Bitewings - four radiographic images$32
Preventive ServicesMember Pays
D1110Prophylaxis - adult$45
D1120Prophylaxis - child$39
Restorative ServicesMember Pays
D2330Resin-based composite - one surface, anterior$80
D2391Resin-based composite - one surface, posterior$101
D2750Crown - porcelain fused to high noble metal$701
D2790Crown - full cast high noble metal$687
Endodontic ServicesMember Pays
D3310Endodontic therapy, anterior tooth (excluding final restoration)$399
D3330Endodontic therapy, molar tooth (excluding final restoration)$607
Periodontic ServicesMember Pays
D4341Periodontal scaling and root planing - four or more teeth per quadrant$138
D4910Periodontal maintenance$88
Prosthodontic Services (removable)Member Pays
D5110Complete denture - maxillary$884
D5120Complete denture - mandibular$884
D5213Maxillary partial denture - cast metal framework with resin denture bases (including retentive/clasping materials, rests and teeth)$1,007
D5214Mandibular partial denture - cast metal framework with resin denture bases (including retentive/clasping materials, rests and teeth)$1,007
D5750Reline complete maxillary denture (indirect)$258
D5751Reline complete mandibular denture (indirect)$258
Oral Surgery ServicesMember Pays
D7140Extraction, erupted tooth or exposed root (elevation and/or forceps removal)$80
Adjunctive ServicesMember Pays
D9215Local anesthesia in conjunction with operative or surgical procedures$19
D9230Inhalation of nitrous oxide/analgesia, anxiolysis$34

Exclusions and Limitations

  1. Fees subject to change.
  2. The dollar amount specified adjacent to each procedure may not be the only cost incurred for a given treatment - many treatments may require more than one dental procedure. Please consult your provider for a detailed treatment plan prior to beginning any work.
  3. The administrator can not guarantee the continued participation of any dentist. If the dentist leaves the plan, you will need to select another participating provider. Not all types of dentists may be available in your area.
  4. It is the member’s responsibility to verify that the dentist is a participating provider before seeking any treatment. Any dental procedures performed by a nonparticipating dentist are not discounted and are charged at the dentist's normal fees.
  5. While all participating Careington providers are professionally licensed in the state in which they practice, Careington does not guarantee the quality of service of the providers. Any quality of care concerns involving any participating Careington provider should be directed in writing to: Careington International Corporation, Attn. Provider Relations, PO Box 2568, Frisco, Texas 75034.
DISCLAIMER:THIS PLAN IS NOT INSURANCE and is not intended to replace health insurance. This plan does not meet the minimum creditable coverage requirements under M.G.L. c.111M and 956 CMR 5.00. This plan is not a Qualified Health Plan under the Affordable Care Act. The range of discounts will vary depending on the type of provider and service. The plan does not pay providers directly. Plan members must pay for all services but will receive a discount from participating providers. The list of participating providers is on this page . A written list of participating providers is available upon request. You may cancel within the first 30 days after effective date or receipt of membership materials (whichever is later) and receive a full refund, less a nominal processing fee (nominal fee for MD residents is $5, AR and TN residents will be refunded processing fee). Discount Plan Organization and administrator: Careington International Corporation, 7400 Gaylord Parkway, Frisco, TX 75034.

This plan is not available in Vermont or Washington.

Effective January 1, 2023

Member Sample Schedule: 504 (2023 CDT Compliant)

Schedule of Services

  • This sample schedule is an abbreviated list taken from the full Careington Care 500 fee schedule and applies to services provided by a participating general dentist. The purpose of this schedule is to establish the maximum fee that a general dentist will charge for each listed procedure. Participant is responsible for full payment of all charges at the time of service.
  • Your participating provider will have a complete fee schedule, or you may request one by calling us.
  • Participating Specialists (Board Certified or Advanced Degree) do not charge according to a fee schedule. Participating Specialists will give a 20% discount off of their normal fees.
  • Discount plans are not insurance.
Careington Care 500 Member Schedule - 505
Diagnostic ServicesMember Pays
D0120Periodic oral evaluation - established patient$21
D0150Comprehensive oral evaluation - new or established patient$27
D0270Bitewing - single radiographic image$16
D0272Bitewings - two radiographic images$20
D0273Bitewings - three radiographic images$26
D0274Bitewings - four radiographic images$33
Preventive ServicesMember Pays
D1110Prophylaxis - adult$48
D1120Prophylaxis - child$40
Restorative ServicesMember Pays
D2330Resin-based composite - one surface, anterior$83
D2391Resin-based composite - one surface, posterior$109
D2750Crown - porcelain fused to high noble metal$749
D2790Crown - full cast high noble metal$722
Endodontic ServicesMember Pays
D3310Endodontic therapy, anterior tooth (excluding final restoration)$450
D3330Endodontic therapy, molar tooth (excluding final restoration)$667
Periodontic ServicesMember Pays
D4341Periodontal scaling and root planing - four or more teeth per quadrant$149
D4910Periodontal maintenance$95
Prosthodontic Services (removable)Member Pays
D5110Complete denture - maxillary$972
D5120Complete denture - mandibular$972
D5213Maxillary partial denture - cast metal framework with resin denture bases (including retentive/clasping materials, rests and teeth)$1,086
D5214Mandibular partial denture - cast metal framework with resin denture bases (including retentive/clasping materials, rests and teeth)$1,086
D5750Reline complete maxillary denture (indirect)$271
D5751Reline complete mandibular denture (indirect)$271
Oral Surgery ServicesMember Pays
D7140Extraction, erupted tooth or exposed root (elevation and/or forceps removal)$83
Adjunctive ServicesMember Pays
D9215Local anesthesia in conjunction with operative or surgical procedures$20
D9230Inhalation of nitrous oxide/analgesia, anxiolysis$34

Exclusions and Limitations

  1. Fees subject to change.
  2. The dollar amount specified adjacent to each procedure may not be the only cost incurred for a given treatment - many treatments may require more than one dental procedure. Please consult your provider for a detailed treatment plan prior to beginning any work.
  3. The administrator can not guarantee the continued participation of any dentist. If the dentist leaves the plan, you will need to select another participating provider. Not all types of dentists may be available in your area.
  4. It is the member’s responsibility to verify that the dentist is a participating provider before seeking any treatment. Any dental procedures performed by a nonparticipating dentist are not discounted and are charged at the dentist's normal fees.
  5. While all participating Careington providers are professionally licensed in the state in which they practice, Careington does not guarantee the quality of service of the providers. Any quality of care concerns involving any participating Careington provider should be directed in writing to: Careington International Corporation, Attn. Provider Relations, PO Box 2568, Frisco, Texas 75034.
DISCLAIMER:THIS PLAN IS NOT INSURANCE and is not intended to replace health insurance. This plan does not meet the minimum creditable coverage requirements under M.G.L. c.111M and 956 CMR 5.00. This plan is not a Qualified Health Plan under the Affordable Care Act. The range of discounts will vary depending on the type of provider and service. The plan does not pay providers directly. Plan members must pay for all services but will receive a discount from participating providers. The list of participating providers is on this page . A written list of participating providers is available upon request. You may cancel within the first 30 days after effective date or receipt of membership materials (whichever is later) and receive a full refund, less a nominal processing fee (nominal fee for MD residents is $5, AR and TN residents will be refunded processing fee). Discount Plan Organization and administrator: Careington International Corporation, 7400 Gaylord Parkway, Frisco, TX 75034.

This plan is not available in Vermont or Washington.

Effective January 1, 2023

Member Sample Schedule: 505 (2023 CDT Compliant)

Schedule of Services

  • This sample schedule is an abbreviated list taken from the full Careington Care 500 fee schedule and applies to services provided by a participating general dentist. The purpose of this schedule is to establish the maximum fee that a general dentist will charge for each listed procedure. Participant is responsible for full payment of all charges at the time of service.
  • Your participating provider will have a complete fee schedule, or you may request one by calling us.
  • Participating Specialists (Board Certified or Advanced Degree) do not charge according to a fee schedule. Participating Specialists will give a 20% discount off of their normal fees.
  • Discount plans are not insurance.
Careington Care 500 Member Schedule - 506
Diagnostic ServicesMember Pays
D0120Periodic oral evaluation - established patient$25
D0150Comprehensive oral evaluation - new or established patient$36
D0270Bitewing - single radiographic image$17
D0272Bitewings - two radiographic images$21
D0273Bitewings - three radiographic images$27
D0274Bitewings - four radiographic images$33
Preventive ServicesMember Pays
D1110Prophylaxis - adult$56
D1120Prophylaxis - child$45
Restorative ServicesMember Pays
D2330Resin-based composite - one surface, anterior$95
D2391Resin-based composite - one surface, posterior$122
D2750Crown - porcelain fused to high noble metal$836
D2790Crown - full cast high noble metal$855
Endodontic ServicesMember Pays
D3310Endodontic therapy, anterior tooth (excluding final restoration)$513
D3330Endodontic therapy, molar tooth (excluding final restoration)$763
Periodontic ServicesMember Pays
D4341Periodontal scaling and root planing - four or more teeth per quadrant$172
D4910Periodontal maintenance$107
Prosthodontic Services (removable)Member Pays
D5110Complete denture - maxillary$1,107
D5120Complete denture - mandibular$1,107
D5213Maxillary partial denture - cast metal framework with resin denture bases (including retentive/clasping materials, rests and teeth)$1,245
D5214Mandibular partial denture - cast metal framework with resin denture bases (including retentive/clasping materials, rests and teeth)$1,245
D5750Reline complete maxillary denture (indirect)$299
D5751Reline complete mandibular denture (indirect)$299
Oral Surgery ServicesMember Pays
D7140Extraction, erupted tooth or exposed root (elevation and/or forceps removal)$95
Adjunctive ServicesMember Pays
D9215Local anesthesia in conjunction with operative or surgical procedures$25
D9230Inhalation of nitrous oxide/analgesia, anxiolysis$41

Exclusions and Limitations

  1. Fees subject to change.
  2. The dollar amount specified adjacent to each procedure may not be the only cost incurred for a given treatment - many treatments may require more than one dental procedure. Please consult your provider for a detailed treatment plan prior to beginning any work.
  3. The administrator can not guarantee the continued participation of any dentist. If the dentist leaves the plan, you will need to select another participating provider. Not all types of dentists may be available in your area.
  4. It is the member’s responsibility to verify that the dentist is a participating provider before seeking any treatment. Any dental procedures performed by a nonparticipating dentist are not discounted and are charged at the dentist's normal fees.
  5. While all participating Careington providers are professionally licensed in the state in which they practice, Careington does not guarantee the quality of service of the providers. Any quality of care concerns involving any participating Careington provider should be directed in writing to: Careington International Corporation, Attn. Provider Relations, PO Box 2568, Frisco, Texas 75034.
DISCLAIMER:THIS PLAN IS NOT INSURANCE and is not intended to replace health insurance. This plan does not meet the minimum creditable coverage requirements under M.G.L. c.111M and 956 CMR 5.00. This plan is not a Qualified Health Plan under the Affordable Care Act. The range of discounts will vary depending on the type of provider and service. The plan does not pay providers directly. Plan members must pay for all services but will receive a discount from participating providers. The list of participating providers is on this page . A written list of participating providers is available upon request. You may cancel within the first 30 days after effective date or receipt of membership materials (whichever is later) and receive a full refund, less a nominal processing fee (nominal fee for MD residents is $5, AR and TN residents will be refunded processing fee). Discount Plan Organization and administrator: Careington International Corporation, 7400 Gaylord Parkway, Frisco, TX 75034.

This plan is not available in Vermont or Washington.

Effective January 1, 2023

Member Sample Schedule: 506 (2023 CDT Compliant)

Schedule of Services

  • This sample schedule is an abbreviated list taken from the full Careington Care 500 fee schedule and applies to services provided by a participating general dentist. The purpose of this schedule is to establish the maximum fee that a general dentist will charge for each listed procedure. Participant is responsible for full payment of all charges at the time of service.
  • Your participating provider will have a complete fee schedule, or you may request one by calling us.
  • Participating Specialists (Board Certified or Advanced Degree) do not charge according to a fee schedule. Participating Specialists will give a 20% discount off of their normal fees.
  • Discount plans are not insurance.
Careington Care 500 Member Schedule - 507
Diagnostic ServicesMember Pays
D0120Periodic oral evaluation - established patient$26
D0150Comprehensive oral evaluation - new or established patient$44
D0270Bitewing - single radiographic image$14
D0272Bitewings - two radiographic images$20
D0273Bitewings - three radiographic images$25
D0274Bitewings - four radiographic images$29
Preventive ServicesMember Pays
D1110Prophylaxis - adult$49
D1120Prophylaxis - child$39
Restorative ServicesMember Pays
D2330Resin-based composite - one surface, anterior$77
D2391Resin-based composite - one surface, posterior$87
D2750Crown - porcelain fused to high noble metal$667
D2790Crown - full cast high noble metal$646
Endodontic ServicesMember Pays
D3310Endodontic therapy, anterior tooth (excluding final restoration)$380
D3330Endodontic therapy, molar tooth (excluding final restoration)$576
Periodontic ServicesMember Pays
D4341Periodontal scaling and root planing - four or more teeth per quadrant$133
D4910Periodontal maintenance$77
Prosthodontic Services (removable)Member Pays
D5110Complete denture - maxillary$859
D5120Complete denture - mandibular$859
D5213Maxillary partial denture - cast metal framework with resin denture bases (including retentive/clasping materials, rests and teeth)$924
D5214Mandibular partial denture - cast metal framework with resin denture bases (including retentive/clasping materials, rests and teeth)$929
D5750Reline complete maxillary denture (indirect)$263
D5751Reline complete mandibular denture (indirect)$259
Oral Surgery ServicesMember Pays
D7140Extraction, erupted tooth or exposed root (elevation and/or forceps removal)$80
Adjunctive ServicesMember Pays
D9215Local anesthesia in conjunction with operative or surgical procedures$25
D9230Inhalation of nitrous oxide/analgesia, anxiolysis$34

Exclusions and Limitations

  1. Fees subject to change.
  2. The dollar amount specified adjacent to each procedure may not be the only cost incurred for a given treatment - many treatments may require more than one dental procedure. Please consult your provider for a detailed treatment plan prior to beginning any work.
  3. The administrator can not guarantee the continued participation of any dentist. If the dentist leaves the plan, you will need to select another participating provider. Not all types of dentists may be available in your area.
  4. It is the member’s responsibility to verify that the dentist is a participating provider before seeking any treatment. Any dental procedures performed by a nonparticipating dentist are not discounted and are charged at the dentist's normal fees.
  5. While all participating Careington providers are professionally licensed in the state in which they practice, Careington does not guarantee the quality of service of the providers. Any quality of care concerns involving any participating Careington provider should be directed in writing to: Careington International Corporation, Attn. Provider Relations, PO Box 2568, Frisco, Texas 75034.
DISCLAIMER:THIS PLAN IS NOT INSURANCE and is not intended to replace health insurance. This plan does not meet the minimum creditable coverage requirements under M.G.L. c.111M and 956 CMR 5.00. This plan is not a Qualified Health Plan under the Affordable Care Act. The range of discounts will vary depending on the type of provider and service. The plan does not pay providers directly. Plan members must pay for all services but will receive a discount from participating providers. The list of participating providers is on this page . A written list of participating providers is available upon request. You may cancel within the first 30 days after effective date or receipt of membership materials (whichever is later) and receive a full refund, less a nominal processing fee (nominal fee for MD residents is $5, AR and TN residents will be refunded processing fee). Discount Plan Organization and administrator: Careington International Corporation, 7400 Gaylord Parkway, Frisco, TX 75034.

This plan is not available in Vermont or Washington.

Effective January 1, 2023

Member Sample Schedule: 507 (2023 CDT Compliant)

Schedule of Services

  • This sample schedule is an abbreviated list taken from the full Careington Care 500 fee schedule and applies to services provided by a participating general dentist. The purpose of this schedule is to establish the maximum fee that a general dentist will charge for each listed procedure. Participant is responsible for full payment of all charges at the time of service.
  • Your participating provider will have a complete fee schedule, or you may request one by calling us.
  • Participating Specialists (Board Certified or Advanced Degree) do not charge according to a fee schedule. Participating Specialists will give a 20% discount off of their normal fees.
  • Discount plans are not insurance.
Careington Care 500 Member Schedule - 508
Diagnostic ServicesMember Pays
D0120Periodic oral evaluation - established patient$28
D0150Comprehensive oral evaluation - new or established patient$47
D0270Bitewing - single radiographic image$15
D0272Bitewings - two radiographic images$25
D0273Bitewings - three radiographic images$29
D0274Bitewings - four radiographic images$35
Preventive ServicesMember Pays
D1110Prophylaxis - adult$58
D1120Prophylaxis - child$40
Restorative ServicesMember Pays
D2330Resin-based composite - one surface, anterior$94
D2391Resin-based composite - one surface, posterior$107
D2750Crown - porcelain fused to high noble metal$785
D2790Crown - full cast high noble metal$759
Endodontic ServicesMember Pays
D3310Endodontic therapy, anterior tooth (excluding final restoration)$441
D3330Endodontic therapy, molar tooth (excluding final restoration)$677
Periodontic ServicesMember Pays
D4341Periodontal scaling and root planing - four or more teeth per quadrant$164
D4910Periodontal maintenance$88
Prosthodontic Services (removable)Member Pays
D5110Complete denture - maxillary$991
D5120Complete denture - mandibular$991
D5213Maxillary partial denture - cast metal framework with resin denture bases (including retentive/clasping materials, rests and teeth)$1,070
D5214Mandibular partial denture - cast metal framework with resin denture bases (including retentive/clasping materials, rests and teeth)$1,070
D5750Reline complete maxillary denture (indirect)$315
D5751Reline complete mandibular denture (indirect)$315
Oral Surgery ServicesMember Pays
D7140Extraction, erupted tooth or exposed root (elevation and/or forceps removal)$94
Adjunctive ServicesMember Pays
D9215Local anesthesia in conjunction with operative or surgical procedures$33
D9230Inhalation of nitrous oxide/analgesia, anxiolysis$44

Exclusions and Limitations

  1. Fees subject to change.
  2. The dollar amount specified adjacent to each procedure may not be the only cost incurred for a given treatment - many treatments may require more than one dental procedure. Please consult your provider for a detailed treatment plan prior to beginning any work.
  3. The administrator can not guarantee the continued participation of any dentist. If the dentist leaves the plan, you will need to select another participating provider. Not all types of dentists may be available in your area.
  4. It is the member’s responsibility to verify that the dentist is a participating provider before seeking any treatment. Any dental procedures performed by a nonparticipating dentist are not discounted and are charged at the dentist's normal fees.
  5. While all participating Careington providers are professionally licensed in the state in which they practice, Careington does not guarantee the quality of service of the providers. Any quality of care concerns involving any participating Careington provider should be directed in writing to: Careington International Corporation, Attn. Provider Relations, PO Box 2568, Frisco, Texas 75034.
DISCLAIMER:THIS PLAN IS NOT INSURANCE and is not intended to replace health insurance. This plan does not meet the minimum creditable coverage requirements under M.G.L. c.111M and 956 CMR 5.00. This plan is not a Qualified Health Plan under the Affordable Care Act. The range of discounts will vary depending on the type of provider and service. The plan does not pay providers directly. Plan members must pay for all services but will receive a discount from participating providers. The list of participating providers is on this page . A written list of participating providers is available upon request. You may cancel within the first 30 days after effective date or receipt of membership materials (whichever is later) and receive a full refund, less a nominal processing fee (nominal fee for MD residents is $5, AR and TN residents will be refunded processing fee). Discount Plan Organization and administrator: Careington International Corporation, 7400 Gaylord Parkway, Frisco, TX 75034.

This plan is not available in Vermont or Washington.

Effective January 1, 2023

Member Sample Schedule: 508 (2023 CDT Compliant)

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