Procedure | ADA Code | Usual Fee1 | With Plan2 | You Save | % Saved |
---|---|---|---|---|---|
Routine 6 month check-up | ADA Code: D0120 | Usual Fee1: $56.00 | With Plan2: $22 | You Save: $34 | Saving Percentage: 61% |
In depth check-up | ADA Code: D0150 | Usual Fee1: $98.00 | With Plan2: $32 | You Save: $66 | Saving Percentage: 67% |
Full mouth x-rays | ADA Code: D0210 | Usual Fee1: $148.00 | With Plan2: $62 | You Save: $86 | Saving Percentage: 58% |
Four bitewing x-rays | ADA Code: D0274 | Usual Fee1: $70.00 | With Plan2: $27 | You Save: $43 | Saving Percentage: 61% |
Panoramic film | ADA Code: D0330 | Usual Fee1: $125.00 | With Plan2: $48 | You Save: $77 | Saving Percentage: 62% |
Adult teeth cleaning | ADA Code: D1110 | Usual Fee1: $99.00 | With Plan2: $48 | You Save: $51 | Saving Percentage: 52% |
Child teeth cleaning | ADA Code: D1120 | Usual Fee1: $76.00 | With Plan2: $33 | You Save: $43 | Saving Percentage: 57% |
Protective sealant / tooth | ADA Code: D1351 | Usual Fee1: $60.00 | With Plan2: $27 | You Save: $33 | Saving Percentage: 55% |
1 surface silver filling for primary or permanent tooth | ADA Code: D2140 | Usual Fee1: $180.00 | With Plan2: $48 | You Save: $132 | Saving Percentage: 73% |
1 surface white filling for u or l front tooth | ADA Code: D2330 | Usual Fee1: $195.00 | With Plan2: $63 | You Save: $132 | Saving Percentage: 68% |
Single crown - porcelain on high noble metal | ADA Code: D2750 | Usual Fee1: $1265.00 | With Plan2: $563 | You Save: $702 | Saving Percentage: 55% |
Single crown - porcelain on noble metal | ADA Code: D2752 | Usual Fee1: $1435.00 | With Plan2: $517 | You Save: $918 | Saving Percentage: 64% |
Core build-up with pins | ADA Code: D2950 | Usual Fee1: $300.00 | With Plan2: $93 | You Save: $207 | Saving Percentage: 69% |
Labial veneer (resin laminate) - direct | ADA Code: D2960 | Usual Fee1: $730.00 | With Plan2: $242 | You Save: $488 | Saving Percentage: 67% |
Labial veneer (porcelain laminate) - indirect | ADA Code: D2962 | Usual Fee1: $1489.00 | With Plan2: $387 | You Save: $1,102 | Saving Percentage: 74% |
Root canal treatment - front tooth | ADA Code: D3310 | Usual Fee1: $1015.00 | With Plan2: $326 | You Save: $689 | Saving Percentage: 68% |
Root canal treatment - bicuspid | ADA Code: D3320 | Usual Fee1: $1151.00 | With Plan2: $380 | You Save: $771 | Saving Percentage: 67% |
Root canal treatment - molar | ADA Code: D3330 | Usual Fee1: $1395.00 | With Plan2: $513 | You Save: $882 | Saving Percentage: 63% |
Bone replacement graft - retained natural tooth - first site in quadrant | ADA Code: D4263 | Usual Fee1: $600.00 | With Plan2: $202 | You Save: $398 | Saving Percentage: 66% |
Perio scaling and root planing (per quadrant) | ADA Code: D4341 | Usual Fee1: $289.00 | With Plan2: $104 | You Save: $185 | Saving Percentage: 64% |
Regular cleaning following periodontic procedure | ADA Code: D4910 | Usual Fee1: $150.00 | With Plan2: $79 | You Save: $71 | Saving Percentage: 47% |
Full upper denture | ADA Code: D5110 | Usual Fee1: $1975.00 | With Plan2: $737 | You Save: $1,238 | Saving Percentage: 63% |
Full lower denture | ADA Code: D5120 | Usual Fee1: $1988.00 | With Plan2: $737 | You Save: $1,251 | Saving Percentage: 63% |
Add clasp to existing partial denture | ADA Code: D5660 | Usual Fee1: $237.00 | With Plan2: $105 | You Save: $132 | Saving Percentage: 56% |
Surgical placement of implant body: endosteal implant | ADA Code: D6010 | Usual Fee1: $2086.00 | With Plan2: $1,788 | You Save: $298 | Saving Percentage: 14% |
Abutment supported cast metal crown (predominantly base metal) | ADA Code: D6063 | Usual Fee1: $1338.00 | With Plan2: $555 | You Save: $783 | Saving Percentage: 59% |
Implant supported crown high noble alloys | ADA Code: D6067 | Usual Fee1: $1638.00 | With Plan2: $725 | You Save: $913 | Saving Percentage: 56% |
Tooth replacement part of permanent bridge | ADA Code: D6210 | Usual Fee1: $1400.00 | With Plan2: $530 | You Save: $870 | Saving Percentage: 62% |
Single tooth removal - simple extraction | ADA Code: D7140 | Usual Fee1: $215.00 | With Plan2: $58 | You Save: $157 | Saving Percentage: 73% |
Extraction - impacted wisdom tooth (soft tissue) | ADA Code: D7220 | Usual Fee1: $402.00 | With Plan2: $143 | You Save: $259 | Saving Percentage: 64% |
Extraction - impacted wisdom tooth (partial bony) | ADA Code: D7230 | Usual Fee1: $484.00 | With Plan2: $192 | You Save: $292 | Saving Percentage: 60% |
Comprehensive orthodontic treatment of the transitional dentition | ADA Code: D8070 | Usual Fee1: $5562.00 | With Plan2: 20% Off | You Save: $1112.40* | Saving Percentage: 20% |
Full orthodontic child treatment (braces) | ADA Code: D8080 | Usual Fee1: $5658.00 | With Plan2: 20% Off | You Save: $1131.60* | Saving Percentage: 20% |
Full orthodontic adult treatment (braces) | ADA Code: D8090 | Usual Fee1: $5936.00 | With Plan2: 20% Off | You Save: $1187.20* | Saving Percentage: 20% |
External bleaching – per arch – performed in office | ADA Code: D9972 | Usual Fee1: $250.00 | With Plan2: 20% Off | You Save: $50.00* | Saving Percentage: 20% |
External bleaching - per tooth | ADA Code: D9973 | Usual Fee1: $185.00 | With Plan2: $147 | You Save: $38 | Saving Percentage: 21% |
Internal bleaching - per tooth | ADA Code: D9974 | Usual Fee1: $250.00 | With Plan2: 20% Off | You Save: $50.00* | Saving Percentage: 20% |
1 The [“Usual Fee”] is determined by DentalPlans.com, Inc., using benchmark data from FAIR Health, Inc. FAIR Health data is used under license. Fees may reflect combined fees from several different procedures into one procedure and may not be directly comparable to a specific benchmark in FAIR Health Data. Actual fees charged by your provider may vary for a variety of reasons.
2 Discounted fees are listed for visits to a participating general dentist. Any procedure not listed on the complete fee schedule will be discounted 20% off the provider's normal fee. Members will be charged the provider's Alliance HealthCard Savings Card contracted fees. Charges may vary from the sample fee schedule above. Consult with your provider prior to beginning any treatment.
This plan is based geographically by ZIP code in terms of provider participation and location. Fee schedules and savings may vary by ZIP code and by Provider within a ZIP code.
* Savings will be 20% off usual customary rate.
Discount prescription drug programs are a valued alternative to traditional insurance plans or a supplement when your insurance plan does not offer a prescription drug card. Quality family health care is very important to your peace of mind. Your Alliance HealthCard Membership entitles everyone in your immediate family to valuable discounts of 20%-60% off the retail prices of many generic prescription drugs and 20%-40% off brand name prescription drugs. With Alliance HealthCard there are no exclusions for brand name drugs or generic drugs. There are no limits on quantities and there is never any paperwork to complete because the savings are immediately available. The program also includes access to our mail order pharmacy for the greatest savings on maintenance prescription drugs.
Over 58,000 Places You Can Save!
Your discount prescription drug card is accepted at over 58,000 retail pharmacies including: Albertson’s, CVS, Eckerd’s, Duane Reade, K-Mart, Kroger, Longs Drugs, Medicine Shoppe, Osco, Publix, Rite Aid, Safeway, Target, Walgreens, Winn-Dixie, and over 25,000 independent retail pharmacies!
Sample Savings | |||
---|---|---|---|
Prescription | Retail Price | With Alliance HealthCard | Savings |
Celebrex 100mg | $59 | $50 | 15% |
Lipitor 20mg | $114 | $100 | 12% |
Nexium 20mg | $140 | $122 | 13% |
Prozac 20mg | $129 | $83 | 36% |
Singulair 10mg | $101 | $87 | 14% |
Lamisil 1% | $41 | $33 | 19% |
Paxil 10mg | $92 | $81 | 12% |
Cialis 10mg | $109 | $98 | 6% |
Zantac 150mg | $14 | $12 | 11% |
This is NOT insurance, it is a discount program.
A vision discount program is a great investment in your family’s well being. Your Alliance HealthCard membership entitles you to a vision service program delivered by a network of eye care professionals. Each one is dedicated to providing quality vision care and products to everyone in your immediate family. There are no limits to the number of visits throughout the year and you simply pay the total bill, less the applicable discount, at the time of service.
Sample Savings on Vision Care | |||
---|---|---|---|
Service | Retail Price | With Alliance HealthCard | Savings |
Exam & Glasses | $300 | $145 | $155 (52%) |
Save 35% on hearing aids with your membership.
Have access to the more than 2,500 full service centers. Receive a FREE hearing aid evaluation and enjoy a three year supply of free batteries with purchase.
There is no charge for annual follow-up cleaning and check of hearing aids purchased through the Alliance HealthCard Membership.
Not available in IL.
Get “corporate rates” with your membership.
Be assured of a guaranteed best-available “corporate” rate with an Alliance HealthCard Membership. There are more than 2,500 participating fitness facilities such as Curves, Gold’s Gym, Jazzercise, and many other locally and regional owned locations.
Get important medical information by phone with your membership.
It is important to have easy access to a trusted source of information and support made available through your Alliance HealthCard Membership. You will speak with a registered nurse who can answer your questions and provide you with health and medical information. All interactions are kept strictly confidential. You can get information about symptoms, medical terms, procedures, diseases, treatment options, and medications. The 24-Hour Nurse Line is standing by for your entire family to have: