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04/17/2008 <br />Proposed Fee Changes for FY 2008-09 <br />Description Current Fee Proposed Fee FY <br />2008-09 <br />Animal Contro/~ <br />Failure to Vaccinate against Rabies $100 $200 <br />Failure to License $50 $200 <br />Mistreatment $50 $200 <br />Public Nuisance Violations $25, $50, $100, $150, <br />$200 $50, $100, $200, $300, <br />$400 <br /> <br />Health Denfal Services z <br />Comprehensive Oral Evaluation $48 $50 <br />Periodic Oral Evaluation $40 $42 <br />Limited Oral Evaluation $40 $42 <br />Re-evaluation-limited, problem $27 $28 <br />Consultation $50 $52 <br />Panoramic Film $64 $67 <br />BWX 1 Film $26 $27 <br />BWX 2 Films $27 $28 <br />Bitewings- lhre films $30 $31 <br />BWX 4 Films $37 $38 <br />1st Intraoral PA Film $25 $26 <br />Additional PA Film $23 $24 <br />Intraoral Occulusal Film $26 $27 <br />Full Mouth Series w BWX $81 $84 <br />Prophy/Child under age 13 $41 $43 <br />Prophy/Adult age 13 and up $60 $62 <br />Fluoride Varnish (age 13&under) $29 $30 <br />Fluoride Varnish (age 13-20) $29 $30 <br />Topical Fluoride varnish;therapeutic application for moderate to high <br />caries risk patients $28 $29 <br />SealantlNEWLY ERUPTED TEETH $34 $35 <br />Scale/Root Planing 1-3 teeth p/q $95 $99 <br />Scale Root Planing 4> teeth p/q $101 $105 <br />Full mouth Debridement $87 $90 <br />Periodontal Maintenance $75 $78 <br />Amal One Surtace Prim/ Perm $75 $78 <br />Amal Two Surface Prim/ Perm $86 $89 <br />Amal Three Surface PrimlPerm $109 $113 <br />Amal Four Surface Prim/Perm $122 $127 <br />Resin One Surface Anterior $69 $72 <br />Resin Two Surface Anterior $88 $92 <br />Resin Three Surface Anterior $109 $113 <br />Resin Four Surface Anterior $125 $130 <br />Resin Comp. Crown Ant. Prim $156 $164 <br />Resin Comp. isur.Post-Prim/Perm $85 $88 <br />Resin Comp. 2sur.Post-Prim/Perm $124 $129 <br />Resin Comp. 3sur.Posterior Perm $159 $165 <br />Resin Comp.4+sur.Posterior Perm $195 $203 <br />Application of Desensitizing Medicament $25 $26 <br />Application of Desensitizing Resin for cervical and/or root surface per <br />tooth $25 $26 <br />Pulpotomy $97 $101 <br />SSC Primary Tooth $154 $160 <br />SSC Permanent Tooth $183 $190 <br />Prebacricated Resin Crown $193 $201 <br />Prefab.est.coat SSC prim. Tooth $177 $184 <br />Sedative Filling $68 $71 <br />Palliative Treatment $56 $58 <br />Ext. Erupted Tooth Prim/Perm $69 $72 <br />Extraction Surgical -100+ $107 $111 <br />Ext. cornal remnants deciduous $50 $52 <br />Alveoplasty extractions p/quad $92 $108 <br />Alveloplasty in conjunction with extraction 1-3 teeth per quadrant $100 $104 <br />Alveloplasty not in conjunction with extraction 4 or more tooth spaces <br />per quadrant $175 $182 <br />Page 1 of 6 <br />