| ADA Service Code—————————————————– | Usual Fee—- | Member Fee– | Discount % |
| D5211 Maxillary partial denture – resin base | $1,313.00 | $525.00 | 60 % |
| D5212 Mandibular partial denture – resin base | $1,313.00 | $525.00 | 60 % |
| D5213 Maxillary partial denture – cast metal | $1,767.00 | $695.00 | 61 % |
| D5214 Mandibular partial denture – cast metal | $1,767.00 | $695.00 | 61 % |