Endodontic Costs and Insurance Details
The following is a guide to help you understand the process of seeing a specialist and receiving treatment.
Cost Estimate
Diagnosis
Testing and Evaluation of Tooth
$
823
-
Panoramic X-Ray
-
CBCT 3D Imaging
-
Pulp Testing
-
Evaluation of Teeth, Gums, Oral Health
Popular
Treatment
Average Cost Only. Specific Cost Based on Diagnosis.
$
1,575
-
Non-Surgical Treatment (Root Canal)
-
Restorative (Re-builds)
-
Surgical Treatment (Apicoectomy/Extraction)
-
No pre-determination; same-day treatment.
Popular
How Insurance Decides What to Pay
1
After Treatment
The dentist performs treatment and assigns CDT procedure codes to describe what was done, cost and date of service.
Then sends claim to insurance company.
2
How Insurance Decides What to Pay
Insurance reviews the claim and applies your specific plan rules. They look at the type of service, coverage percentage, and annual maximum.
Typical coverage for major (endodontic) is 50%
3
How Out of Pocket is Figured
Dentist’s fee → plan’s allowed amount → minus insurance → plus any limits or non‑covered items.
4
Explanation of Benefits
After the claim is processed, you receive an EOB from your insurance. This is not a bill; it is a summary of how they handled the claim. You then compare this EOB with the statement from your dentist’s office to see what remains to be paid.
5
Why They Pay Less
Even when we provide an estimate based on your plan information and pre‑determination of benefits, the final payment decision always belongs to your insurance company.
6
Your Plan Rules Limit Coverage
Plan rules like yearly dollar limits, time limits, waiting periods, paying only for a cheaper version of a treatment, not covering certain procedures, using lower fees for out‑of‑network dentists, or how two plans split the bill.