Dental costs by state: the same procedures, compared across the states we price

Why the same crown costs more in one state

Dental fees follow the cost of running an office: staff wages, rent, laboratory work and the number of dentists competing in an area. They also follow what patients are used to paying and what private plans allow. None of these is the same from one state to the next, and the gap is large: for a crown, the highest state priced here is 2.5 times the lowest; for a molar root canal, 3.4 times.

Part of the gap in our estimates also comes from the method. A state's price is its Medicaid fee divided by its own ratio, and both the fee and the ratio are specific to the state. When a Medicaid program pays a code far above or below its usual level compared with dentists' fees, the estimate for that code moves with it. The method page lists this limit with the others, and each state page shows the fees used.

The states side by side

The table gives the estimated full fee, the price billed to a patient with no plan, for five common procedures. Network prices, which private plans allow, are lower and appear on each state page.

Why some cells are empty

A procedure is priced in a state only when the state's Medicaid schedule lists every code it needs. Schedules list what the program pays for, and programs differ: some cover adult dentures but not crowns, some cover orthodontics only for children with a severe condition, and most do not pay for implants or veneers. The site does not fill a gap with a guess or a neighbor's fee. A second rule removes estimates that land far from the other states for the same procedure, below half or above twice their median, because such a gap usually means the state's Medicaid fee for that code is set on another basis than its usual level, not that dentists there charge so differently. The schedule of Massachusetts allows the most procedures to be priced, 17 of the 18 on this site.

In Alabama, Arizona, Florida, Georgia, Missouri, Nevada, Texas, the ADA published no adult ratio for 2024 because Medicaid offered adults no dental benefit beyond emergencies, so adult procedures are estimated with the children's ratio and, where the schedule lists the codes for children only, with the children's fees. Each estimate states which.

Using a state price

A state estimate is an average across offices, cities and countryside. Prices in a large metropolitan area tend to sit above it, and prices in smaller towns below. Its best use is as a check on a written quote: a quote close to the state figure is ordinary; one far above it deserves a question about what it includes, code by code. The insurance calculator then shows what a plan would pay, and the page on paying without insurance covers the options when there is no plan.

Network prices follow the same order between states but sit lower, because private plans negotiate fees below what offices bill patients without a plan. A state where the full fee is high is usually also a state where the network price is high, so a plan does not erase the gap between states; it narrows it in dollars.

Moving across a state line for treatment is rarely as simple as the table suggests: follow-up visits, travel and the warranty an office gives on its own work all count. The comparison is most useful for people who already live near a border, or who are deciding where to have a large treatment done between two homes.

States still to come

Not every state publishes its dental fee schedule in a form that can be read, and some pay dentists only through managed care plans whose rates are private. Other states' schedules for July 2024 could not be found, and without them the estimate would mix fees and ratios from different years. States are added as their documents are read; the Medicaid dental page lists the ADA ratios of all fifty states and the District of Columbia in the meantime.