Exceptional Smiles

Cash prices

1. Comprehensive Exam – D0150

   Standard service: Comprehensive oral exam

   Code D0150

   Ask what's included
   $102 per visit

   Requires Gloss Dental Membership, starting at $25 per month; exam charge is additional.

   Source: exceptionalsmilesdental.com · checked Oct 2026
2. All-Porcelain Crown – D2740

   Standard service: Crown (porcelain/ceramic)

   Code D2740

   Ask what's included
   $1,225

   Requires Gloss Dental Membership, starting at $25 per month; procedure charge is additional.

   Source: exceptionalsmilesdental.com · checked Oct 2026
3. Gloss Dental Membership

   Standard service: Dental membership plan

   Ask what's includedMembership
   from $25 per month

   Plans start at $25 per month; cost varies by plan. Includes yearly cleanings, exams and routine x-rays. Other procedures cost extra at member rates.

   Source: exceptionalsmilesdental.com · checked Oct 2026
4. Sealant – D1351

   Standard service: Dental sealant (per tooth)

   Code D1351

   Ask what's included
   $62

   Requires Gloss Dental Membership, starting at $25 per month; procedure charge is additional.

   Source: exceptionalsmilesdental.com · checked Oct 2026
5. Full-mouth x-rays – D0210

   Standard service: Full mouth X-rays (FMX)

   Code D0210

   Ask what's included
   $146

   Requires Gloss Dental Membership, starting at $25 per month; full-mouth x-ray charge is additional.

   Source: exceptionalsmilesdental.com · checked Oct 2026
6. Panoramic X-ray – D0330

   Standard service: Panoramic X-ray

   Code D0330

   Ask what's included
   $125

   Requires Gloss Dental Membership, starting at $25 per month; panoramic x-ray charge is additional.

   Source: exceptionalsmilesdental.com · checked Oct 2026
7. Perio Maintenance – D4910

   Standard service: Periodontal maintenance

   Code D4910

   Ask what's included
   $149

   Requires Gloss Dental Membership, starting at $25 per month; procedure charge is additional.

   Source: exceptionalsmilesdental.com · checked Oct 2026
8. Perio Maintenance – D4910

   Standard service: Periodontal maintenance

   Code D4910

   Ask what's included
   $149 per visit

   Requires Gloss Dental Membership, starting at $25 per month; procedure charge is additional.

   Source: exceptionalsmilesdental.com · checked Oct 2026
9. Cleaning + Exam + X-rays

   Standard service: Teeth cleaning, exam and X-rays

   Ask what's includedPackage
   $125

   First-visit offer only.

   Source: exceptionalsmilesdental.com · checked Oct 2026
10. Cleaning, Exam & X-Rays - First Visit

    Standard service: Teeth cleaning, exam and X-rays (new patient)

    Ask what's includedNew-patient offer
    $125

    First-visit offer only.

    Source: exceptionalsmilesdental.com · checked Oct 2026
11. Simple Extraction – D7140

    Standard service: Tooth extraction (simple)

    Code D7140

    Ask what's included
    $213

    Requires Gloss Dental Membership, starting at $25 per month; procedure charge is additional.

    Source: exceptionalsmilesdental.com · checked Oct 2026
12. Surgical Extraction – D7210

    Standard service: Tooth extraction, surgical

    Code D7210

    Ask what's included
    $313

    Requires Gloss Dental Membership, starting at $25 per month; procedure charge is additional.

    Source: exceptionalsmilesdental.com · checked Oct 2026
13. 1-surface white resin filling, posterior – D2391

    Standard service: Tooth-colored filling (1 surface, posterior)

    Code D2391

    Ask what's included
    $202

    Posterior filling price. Requires Gloss Dental Membership, starting at $25 per month; filling charge is additional.

    Source: exceptionalsmilesdental.com · checked Oct 2026
14. 1-surface white resin filling, anterior – D2330

    Standard service: Tooth-colored filling, 1 surface (anterior)

    Code D2330

    Ask what's included
    $188

    Anterior filling price. Requires Gloss Dental Membership, starting at $25 per month; filling charge is additional.

    Source: exceptionalsmilesdental.com · checked Oct 2026
15. 2-surface white resin filling, anterior – D2331

    Standard service: Tooth-colored filling, 2 surfaces (anterior)

    Code D2331

    Ask what's included
    $225

    Anterior filling price. Requires Gloss Dental Membership, starting at $25 per month; filling charge is additional.

    Source: exceptionalsmilesdental.com · checked Oct 2026
16. 2-surface white resin filling, posterior – D2392

    Standard service: Tooth-colored filling, 2 surfaces (posterior)

    Code D2392

    Ask what's included
    $260

    Posterior filling price. Requires Gloss Dental Membership, starting at $25 per month; filling charge is additional.

    Source: exceptionalsmilesdental.com · checked Oct 2026
17. Fluoride – D1208

    Standard service: Topical fluoride application

    Code D1208

    Ask what's included
    $44

    Requires Gloss Dental Membership, starting at $25 per month; treatment charge is additional.

    Source: exceptionalsmilesdental.com · checked Oct 2026

Prices are published cash prices with their source and the date we last checked. Confirm with the provider before you book. Hospital prices for a billing code are often the facility charge only.