Orange County NC Website
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FY 2009-10 Proposed Changes to the County Fee Schedule 44 <br />Topical Fluoride varnish;therapeutic <br />application for moderate to high <br />$2g,pp <br />$30.00 <br />2008 <br />SealanUNEWLY ERUPTED TEETH $35.00 $43.00 2008 <br />Scale/Root Planing 1-3 teeth p/ $99.00 $103.00 2008 <br />Scale Root Planin 4> teeth / $105.00 $111.00 2008 <br />Full mouth Debridement $90.00 $101.00 2008 <br />Periodontal Maintenance $78.00 $81.00 2008 <br />Amal One Surface Prim/ Perm $78.00 $89.00 2008 <br />Amal Two Surface Prim/ Perm $89.00 $113.00 2008 <br />Amal Three Surface PrimlPerm $113.00 $137.00 2008 <br />Amai Four Surface Prim/Perm $127.00 $156.00 2008 <br />Resin One Surface Anterior $72.00 $94.00 2008 <br />Resin Two Surface Anterior $92.00 $118.00 2008 <br />Resin Three Surface Anterior $113.00 $141.00 2008 <br />Resin Four Surface Anterior $130.00 $164.00 2008 <br />Resin Com .Crown Ant. Prim $164.00 $185.00 2008 <br />Resin Com . 1sur.Post-Prim/Perm $88.00 $115.00 2008 <br />Resin Com . 2sur.Post-Prim/Perm $129.00 $157.00 2008 <br />Resin Com . 3sur.Posterior Perm $165.00 $207.00 2008 <br />Resin Com .4+sur.Posterior Perm $203.00 $242.00 2008 <br />Application of Desensitizing <br />Medicament <br />$26.00 <br />$37.00 <br />2008 <br />Application of Desensitizing Resin for <br />cervical and/or root surface er tooth <br />$26.00 <br />$52.00 <br />2008 <br />Pulpotom $101.00 $119.00 2008 <br />SSC Prima Tooth $160.00 $201.00 2008 <br />SSC Permanent Tooth $190.00 $229.00 2008 <br />Prebacricated Resin Crown $201.00 $235.00 2008 <br />Prefab.est.coat SSC rim. Tooth $184.00 $214.00 2008 <br />Sedative Filling $71.00 $74.00 2008 <br />Palliative Treatment $58.00 $60.00 2008 <br />Ext. Eru ted Tooth Prim/Perm $72.00 $89.00 2008 <br />Extraction Surgical - 100+ $111.00 $141.00 2008 <br />Ext. cornal remnants deciduous $52.00 $62.00 2008 <br />Alveo last extractions / uad. $108.00 $118.00 2008 <br />Alveloplasty in conjunction with <br />extraction 1-3 teeth per uadrant <br />$104.00 <br />$118.00 <br />2008 <br />Alveloplasty not in conjunction with <br />extraction 4 or more tooth spaces per <br />quadrant <br /> <br />$182.00 <br /> <br />$189.00 <br /> <br />2008 <br />Alveloplasty not in conjunction with <br />extraction 1-3 tooth spaces per <br />quadrant <br /> <br />$156.00 <br /> <br />$162.00 <br /> <br />2008 <br />Recement Crown NOT cov. b MA $55.00 $57.00 2008 <br />Stud Models $50.00 $53.00 2008 <br />I & D Minor Sure $168.00 $186.00 2008 <br />Occulsal Ad'ustment Limited $83.00 $86.00 2008 <br />Fractured Tooth Txt. $67.00 $70.00 2008 <br />Puip Cap-direct exp. Pulp MED $44.00 $46.00 2008 <br />Pul Ca -indirect nears ex osed $44.00 $46.00 <br />~ 2008 <br />Bio s Oral Tissue $144.00 $151.00 2008 <br />Pin Retentfon/tooth $29.00 $30.00 2008 <br />Band & Loo (Quadrant Deliver 209/2 $230.00 $264.00 2008 <br />Fixed Bilateral Deliver 419/30 $463.00 $482.00 2008 <br />Occlusal guard, by report minimize <br />bruxism $274/951ab <br />$285.00 <br />$296.00 ~ <br />2008 <br />Fabrication of Athletic Mouthguard $104.00 $108.00 2008 <br />Root Canal Therap Anterior $416.00 433.00 2008 <br />Root Canai Therap Bicus id $494.00 514.00 2008 <br />Root Canai Thera Molar $624.00 649.00 2008 <br /> <br />Fiat Fees Mouthguard Project 2008 <br />2008 <br />Flat Fee Fabrication of Athletic <br />Mouthguard Projects __ <br />$15.00 <br />$17.00 <br />2008 <br />2of7 <br />