How prices are estimated

Every price on this site is a state's own Medicaid fee for the codes of a procedure, divided by that state's published ratio between Medicaid pay and dentists' charges, then carried to today with the federal price index for dental services. 27 schedules were read code by code; one script, rerun when a document changes, produces every figure.

Price pages at the top of search results quote one national range with no source and then ask for an appointment or a credit application; this site prices each procedure for your state from that state's own published fee schedule, code by code, names and dates the document, and runs your plan's deductible, coinsurance, annual maximum and waiting period on the result.

1. The state fee schedules

Each state Medicaid program publishes the maximum it pays a dentist for each code of the Current Dental Terminology (CDT), the codes that appear on every dental claim. We read the official file of each state, recorded its address and effective date, and kept the codes of the procedures priced here. Where a schedule gives different fees for children and adults, both are kept. Several states pay adults for few services, or none; a code that a state lists for patients under 21 only is used for an adult procedure only with that state's children's ratio, so that fee and ratio describe the same patients.

The ratios described below were built on Medicaid fees collected through July 2024, so the estimate divides the schedule in force on July 1, 2024. Today's schedule is shown beside it, because it is what Medicaid pays now; a state that has raised its fees since 2024 shows a higher current fee, and the estimate does not move with it, since the ratio was not measured on it. A state for which the 2024 edition could not be found is not priced. California is not priced either: its Medi-Cal Dental schedule lists base fees without the supplemental payments that the ADA took into account for that state, so the two would not match.

2. The ADA ratios

The American Dental Association Health Policy Institute's 2024 workbook, published in October 2024, gives for every state two ratios, for children and for adults: Medicaid fee-for-service pay as a share of the average charges of dentists, and as a share of the average payments of private dental insurance. The ADA built them on a basket of common codes (exams, cleanings, X-rays, fillings, extractions), weighted by how often each is billed. Dentist charges cover April 1, 2023 to March 31, 2024; private payments cover the second quarter of 2024. Nationally, Medicaid paid 29.9 % of dentists' charges for adults and 39.2 % for children.

We divide by the first ratio to estimate the full fee, the price billed to a patient with no plan, and by the second to estimate the network price, the amount a private plan allows its network dentists. The dentists' charges themselves come from a commercial database used by the ADA under license; this site uses only the ADA's published percentages, never that database.

3. From 2024 to today

Prices rose after the ADA windows. We multiply the full fee by the change of the consumer price index for dental services between the average of April 1, 2023 to March 31, 2024 and September 2026, a factor of 1.136, and the network price by its change since the second quarter of 2024, a factor of 1.106. Over the last twelve months the index rose 6.0 %.

4. A worked example

A molar root canal (code D3330) in Alabama: the schedule in force on July 1, 2024 paid $660. Alabama's children's ratio is 46.4 % of dentists' charges, so the typical charge in the ADA window was $1,423; times 1.136, that gives $1,617 today. The network price follows the same path with the ratio of 75.0 %: $974.

5. The procedures and their codes

A procedure is the set of codes a dentist usually bills for it. When a slot accepts several codes, the first one the schedule lists is used. A procedure is priced in a state only when every slot is filled; nothing is guessed.

One screen follows. A state's estimate of a procedure is withheld when it falls below 50 % or above 200 % of the median of the states that price it (when at least 3 do). The ratio is measured on common codes, and a state that pays one procedure on another basis, orthodontics by treatment phase or a fee that covers only part of the work, would otherwise print a price several times too low or too high. Corrections printed in a schedule itself, such as Minnesota's instruction to add 98 % to its listed fees, are applied and recorded with their reason.

6. The plan calculations

In network, the patient is billed the network price; out of network, the full fee, and the plan pays on its own allowance, taken here as the network price, so the gap falls to the patient. The deductible comes off first, the plan pays its percentage for the class of the work, and its payment stops at the yearly maximum still available. During a waiting period it pays nothing for that class. Default values come from the Covered California 2026 dental plan designs: deductible $50, yearly maximum $1,500, 80 % for basic and 50 % for major services, a 6-month wait for major services. Financing uses the average rates of the Federal Reserve's G.19 release and the deferred interest rules of Regulation Z.

7. Limits

• A state's ratio is measured on a basket of common codes (exams, cleanings, X-rays, fillings, extractions). Medicaid may pay other codes, such as crowns, implants or orthodontics, closer to or further from dentists' fees than that basket, and no public dataset of dentists' charges by code lets us measure the gap. The estimate of such a procedure carries that error, in either direction. For implants, priced in few states, the full fee estimated here sits well above the ranges that clinics advertise, and the network price is the more prudent reference; treat both as an order of magnitude to check against a written quote.
• Prices are state averages. Fees differ between cities and offices, and by the materials and the lab.
• Many Medicaid programs pay dentists through managed care plans whose rates are not public; the ratios and our estimates use the public fee-for-service schedule.
• Implants and veneers are rarely in Medicaid schedules, so they are priced in few states. Brand-name aligner prices are not published by any public body and are not estimated.
• Nothing here is medical advice or a quote. Only a dentist can say what treatment a mouth needs and what it will cost.

Corrections: contact page.