| ADA Service Code—————————————————- | Usual Fee—- | Member Fee– | Discount % |
| D3220 Pulpotomy | $190.00 | $115.00 | 39 % |
| D3230 Pulp therapy – anterior, primary tooth | $180.00 | $110.00 | 39 % |
| D3240 Pulp therapy – posterior, primary tooth | $195.00 | $123.00 | 37 % |
| D3310 Root Canal Therapy-anterior | $945.00 | $385.00 | 59 % |
| D3320 Root Canal Therapy-bicuspid | $1,050.00 | $450.00 | 57 % |
| D3330 Root Canal Therapy-molar | $1,230.00 | $595.00 | 52 % |
| D3221 Pulpal Debridement, Primary/Permanent | $199.00 | $65.00 | 67 % |