Our Fees
These are our standard published UCR rates for the procedures patients ask about most. Use the category menu to jump to the prices you care about — and check the side panel to see how insurance or our membership plan affects what you actually pay.
UCR stands for Usual, Customary, and Reasonable — the published rates we charge for each procedure before any insurance is applied. Whether you actually pay these amounts depends on how you're covered:
Please call (650) 873-6681 to verify your specific benefits before treatment — we provide written treatment plans with cost estimates at no charge.
Browse fees
Pick a category to jump to its price list. Each row shows the procedure name, the standard CDT code, and our published UCR fee.
Fees current as of 2025-06
Periodic oral evaluation — established patient
CDT D0120
Limited oral evaluation — problem-focused
CDT D0140
Comprehensive oral evaluation — new or established patient
CDT D0150
Intraoral periapical — additional radiographic image
CDT D0230
Intraoral periapical — first radiographic image
CDT D0220
Bitewings — four radiographic images
CDT D0274
Panoramic radiographic image
CDT D0330
Intraoral complete series of radiographic images
CDT D0210
Topical fluoride varnish
CDT D1206
Sealant — per tooth
CDT D1351
Prophylaxis (cleaning) — child
CDT D1120
Prophylaxis (cleaning) — adult
CDT D1110
Have dental insurance?
We accept 14 PPO carriers in-network. Your plan negotiates a contracted allowance — your patient share depends on your specific benefits. Out-of-network? You pay UCR and your plan reimburses you after we file the claim.
Composite filling — 1 surface, anterior
CDT D2330
Composite filling — 1 surface, posterior
CDT D2391
Composite filling — 2 surfaces, anterior
CDT D2331
Composite filling — 2 surfaces, posterior
CDT D2392
Core buildup — including pins when required
CDT D2950
Composite filling — 3 surfaces, posterior
CDT D2393
Composite filling — 4+ surfaces, posterior
CDT D2394
Re-cement or re-bond crown
CDT D2920
Prefabricated post and core (in addition to crown)
CDT D2954
Same-day porcelain / ceramic crown
CDT D2740
Labial porcelain veneer (indirect)
CDT D2962
Custom abutment — includes placement
CDT D6057
Pontic — porcelain fused to high-noble metal (bridge)
CDT D6240
Abutment-supported porcelain / ceramic crown
CDT D6058
Implant-supported porcelain / ceramic crown
CDT D6065
Surgical placement of implant body
CDT D6010
Extraction — erupted tooth or exposed root (simple)
CDT D7140
Extraction — erupted tooth requiring bone removal (surgical)
CDT D7210
No dental insurance?
Three monthly plans for patients without insurance — adult, perio, and child. Includes routine cleanings, exams, X-rays, and discounted pricing on additional treatment. No waiting period.
Emergency visit — limited oral evaluation
CDT D0140
Inhalation of nitrous oxide / analgesia
CDT D9230
Palliative (emergency) treatment of dental pain
CDT D9110
External bleaching (whitening) — per arch, in office
CDT D9972
Occlusal guard — hard appliance, full arch (night guard)
CDT D9944
Comprehensive orthodontic — adult (Invisalign)
CDT D8090
Listed fees are our standard published UCR rates as of 2025-06. The full fee schedule includes 580+ CDT codes — if you need a fee for a procedure not listed here, call us at (650) 873-6681 and we will quote it.
If you have no dental insurance and pay privately, yes — these are our published UCR fees. If you have insurance, your final patient responsibility depends on your plan. In-network plans use a contracted allowance; out-of-network plans reimburse you a portion of UCR after we file the claim. Call us at (650) 873-6681 and we will verify your benefits before treatment.
Most dental plans have a deductible (typically $50–$100/year), co-insurance (you pay a percentage), and an annual maximum benefit (often $1,000–$2,000). What your plan pays depends on the specific procedure, your remaining annual benefit, and whether we are in-network. We provide a written treatment plan with cost estimates at no charge so there are no surprises. See accepted insurance carriers
If we are out-of-network with your plan, your visit cost is the same as a private-pay visit at our published UCR fees. We will file the claim on your behalf — your insurance reimburses you a portion directly. Bring your insurance card to your appointment so we can submit the claim for you.
You can pay UCR directly, or join our membership plan — three monthly tiers (adult, perio, child) that include routine cleanings, exams, and X-rays, plus discounted pricing on additional treatment. No waiting period to enroll. The membership plan is designed specifically for patients without dental insurance.
UCR fees vary by region and by practice. Our published rates reflect what we usually, customarily, and reasonably charge for each procedure at Westborough Dental Care, taking into account our materials, lab partners, and time. We do not adjust UCR fees based on insurance company allowances.
The page above shows the procedures patients ask about most. Our complete fee schedule has 580+ CDT codes. If your insurance has flagged a specific code or you have a written treatment plan from another office, call us at (650) 873-6681 with the CDT code and we will quote it — usually within the same business day.
We provide written treatment plans with cost estimates at no charge. Call us with your insurance card handy and we will confirm exactly what your plan covers.
