Lone Tree Dental Associates

Cash prices

1. Bitewings - Four Radiographic Images

   Standard service: Bitewing X-rays (4 films)

   Code D0274

   Ask what's included
   $70

   Estimated usual and customary fee; actual charges depend on circumstances, including complications or exceptional treatment.

   Source: lonetreedentalassociates.com · checked Oct 2026
2. Resin Composite One Surface Posterior - One Surface

   Standard service: Composite filling, posterior (1 surface)

   Code D2391

   Ask what's included
   $207

   Estimated usual and customary fee; actual charges depend on circumstances, including complications or exceptional treatment.

   Source: lonetreedentalassociates.com · checked Oct 2026
3. Resin Composite Two Surface Posterior - Two Surface

   Standard service: Composite filling, posterior (2 surfaces)

   Code D2392

   Ask what's included
   $231

   Estimated usual and customary fee; actual charges depend on circumstances, including complications or exceptional treatment.

   Source: lonetreedentalassociates.com · checked Oct 2026
4. Resin Composite Three Surface Posterior - Three Surface

   Standard service: Composite filling, posterior (3 surfaces)

   Code D2393

   Ask what's included
   $275

   Estimated usual and customary fee; actual charges depend on circumstances, including complications or exceptional treatment.

   Source: lonetreedentalassociates.com · checked Oct 2026
5. Resin Composite Four/More Surface Posterior - Four/More Surface

   Standard service: Composite filling, posterior (4+ surfaces)

   Code D2394

   Ask what's included
   $315

   Estimated usual and customary fee; actual charges depend on circumstances, including complications or exceptional treatment.

   Source: lonetreedentalassociates.com · checked Oct 2026
6. Comprehensive Oral Evaluation/Established Patient

   Standard service: Comprehensive oral exam (established patient)

   Code D0150

   Ask what's included
   $100

   Estimated usual and customary fee; actual charges depend on circumstances, including complications or exceptional treatment.

   Source: lonetreedentalassociates.com · checked Oct 2026
7. Core Buildup Including Pins

   Standard service: Core buildup (including pins)

   Code D2950

   Ask what's included
   $350

   Estimated usual and customary fee; actual charges depend on circumstances, including complications or exceptional treatment.

   Source: lonetreedentalassociates.com · checked Oct 2026
8. Crown Porcelain Fused High Noble Metal

   Standard service: Crown porcelain fused to high noble metal

   Code D2750

   Ask what's included
   $1,400

   Estimated usual and customary fee; actual charges depend on circumstances, including complications or exceptional treatment.

   Source: lonetreedentalassociates.com · checked Oct 2026
9. Limited Oral Evaluation Problem Focused

   Standard service: Limited dental exam (problem-focused)

   Code D0140

   Ask what's included
   $100

   Estimated usual and customary fee; actual charges depend on circumstances, including complications or exceptional treatment.

   Source: lonetreedentalassociates.com · checked Oct 2026
10. Panoramic Radiographic Image

    Standard service: Panoramic X-ray

    Code D0330

    Ask what's included
    $144

    Estimated usual and customary fee; actual charges depend on circumstances, including complications or exceptional treatment.

    Source: lonetreedentalassociates.com · checked Oct 2026
11. Intraoral Periapical First Radiographic Image

    Standard service: Periapical X-ray (first image)

    Code D0220

    Ask what's included
    $35

    Estimated usual and customary fee; actual charges depend on circumstances, including complications or exceptional treatment.

    Source: lonetreedentalassociates.com · checked Oct 2026
12. Periodic Oral Evaluation

    Standard service: Periodic oral exam

    Code D0120

    Ask what's included
    $75

    Estimated usual and customary fee; actual charges depend on circumstances, including complications or exceptional treatment.

    Source: lonetreedentalassociates.com · checked Oct 2026
13. Surgical Removal Erupted Tooth

    Standard service: Surgical tooth extraction (erupted)

    Code D7210

    Ask what's included
    $416

    Estimated usual and customary fee; actual charges depend on circumstances, including complications or exceptional treatment.

    Source: lonetreedentalassociates.com · checked Oct 2026
14. Prophylaxis Adult - Adult

    Standard service: Teeth cleaning (adult)

    Code D1110

    Ask what's included
    $110

    Estimated usual and customary fee; actual charges depend on circumstances, including complications or exceptional treatment.

    Source: lonetreedentalassociates.com · checked Oct 2026
15. Prophylaxis Child - Child

    Standard service: Teeth cleaning (child)

    Code D1120

    Ask what's included
    $79

    Estimated usual and customary fee; actual charges depend on circumstances, including complications or exceptional treatment.

    Source: lonetreedentalassociates.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.