Call 800 76-SMILE (767-6453) |
2010 SCHEDULE OF ORTHODONTIC
SERVICES
Paul Ouellette, DDS, MS & Associates |
A. Diagnostic Services |
*ADA Code |
Fee Ranges |
Initial Consultation |
0150 |
NO CHARGE |
Recall Consultation |
0120 |
NO CHARGE |
Digital Extra-oral & Intra-oral Imaging
(Photography) |
0350 |
$75 per study |
Digital Study Model Analysis |
0470 |
$150 per study |
Panoramic Digital Radiography |
0330 |
$75 per study |
Cephalometric Digital Radiography |
0340 |
$150 per study |
Case Records Analysis & Diagnostic
Report |
0150 |
$450 per report |
Surgical or Progress Study Models |
0470 |
$150 per study |
Initial Diagnostic Records Inclusive (X-rays or CBCT Scan,
Digital Models, Photos) |
NA |
$450 @Start Visit |
Transfer Case Update Records (X-rays or CBCT Scan,
Digital Models, Photos) |
NA |
$450 @Start Visit |
Diagnostic Records Duplication Fee (X-rays or CBCT Scan,
Digital Models, Photos) |
NA |
$50 - $75 |
Consultation with Other Specialist(s) or
As Expert Witness |
9310 |
$850 per hour |
NOTICE TO NEW PATIENTS:This is our most current 2010 schedule of orthodontic services and general fee ranges BEFOREany discounts. When you visit our office for a NO CHARGE consultation, Doctor Ouellette will determine your case difficulty and estimated treatment time. A detailed explanation of all apparent orthodontic problems will be presented. If orthodontic treatment is necessary, our office will give you a written estimate and a customized payment plan. We accept most insurance plans, credit cards, debit cards and checks. We also offer NO DOWN PAYMENT plans as well as NO INTEREST monthly payment plans. We pride ourselves in making orthodontic treatment AFFORDABLE at Affordablebraces.com. We all look forward to meeting you in the near future. Thank you................................................. Doctor Ouellette & Staff. |
B. Limited Treatment Cases |
*ADA Code |
Fee Ranges |
Limited Treatment of Primary Dentition |
8010 |
$1,500 - $3,600 |
Limited Treatment of Transitional Dentition |
8020 |
$2,500 - $3,800 |
Limited Treatment of Adolescent Dentition |
8030 |
$2,500 - $4,200 |
Limited Treatment of Adult Dentition |
8040 |
$3,600 - $4,600 |
C. Interceptive Treatment
Cases (Phase I) |
*ADA Code |
Fee Ranges |
Interceptive Treatment of Primary Dentition |
8050 |
$2,800 - $3,800 |
Interceptive Treatment of Transitional
Dentition |
8060 |
$2,800 - $3,800 |
D. Comprehensive Treatment
Cases (Phase II) |
*ADA Code |
Fee Ranges |
Comprehensive Treatment of Primary Dentition |
8070 |
$4,900 - $6,500 |
Comprehensive Treatment of Transitional
Dentition |
8080 |
$4,900 - $6,500 |
Comprehensive Treatment of Adolescent &
Adult Dentition |
8090 |
$4,900 - $6,500 |
E. Other Services |
*ADA Code |
Fee Ranges |
Appliance(s) Removal, Construct & Place
Retainer(s) |
8680 |
$950 |
Appliance(s) Removal without Retainer(s) |
8680 |
$150 - $450 |
Initial Retainer Appliance Fee For New
Patients |
8680 |
$350 per arch |
Essix Clear/Invisible Retainer(s) |
8680 |
$175 per arch |
Tooth Positioner Appliance |
8680 |
$350 |
Lost or Broken Retainer(s) For Patients
of Record |
8680 |
$250 per arch |
Broken Retainer(s) Repair (Plus $45 Appt
Fee) |
5610 |
$55 - $150 |
Functional Appliance(s) (Twin Block, Herbst,
European Appliances) |
8680 |
$350 - $1,500 |
Orthopedic Appliance(s) (Chin cup / Face
Mask / Headgears) |
8680 |
$350 - $1,500 |
Occlusal (Bite) Adjustments / Limited |
9951 |
$150 - $300 |
Occlusal (Bite) Adjustments / Complete |
9952 |
$400 |
Fixed Retainer(s) Bonded To Back of Teeth (Clear Essix Retainer(s) Included) |
8680 |
$350 per arch |
Extensive Treatment Planning &/or Surgical
Case Work-up |
9450 |
$1,500 |
After Hours Office Visit / Emergency Care
Visit New Patient |
9440 |
$250 minimum charge |
Extraction of Primary Teeth or Coronal
Remnants |
7111 |
$75 per tooth |
Maxillary Partial Denture (Flipper with
Pontic Teeth) |
5211 |
$750 per arch |
Mandibular Partial Denture (Flipper with
Pontic Teeth) |
5212 |
$750 per arch |
Space Maintainer Bilateral / Fixed |
1515 |
$650 per arch |
Space Maintainer Bilateral / Removable |
1525 |
$650 per arch |
Recementation Space Maintainer |
1550 |
$75 per visit |
Broken or Missed Appointments without Notice |
9999 |
$50 per no show |
Provisional Splinting of Traumatized Teeth
(Extracoronal Stabilization) |
4321 |
$300 - $950 |
Invisalign Comprehensive Treatment (Includes
$1,600 Lab & $200 Materials Fee) |
8090 |
$6,000 - $6,500 |
Invisalign Limited Treatment (Includes
$1600 Lab & $200 Materials Fee) |
8090 |
$4,500 - $5,500 |
Temporary Anchorage Device -- Anesthesia
+ Insertion (per TAD) |
$450 each | |
Power (One hour) Laser Bleaching |
$350 - $500 | |
TRANSFER CASES: In the event you transfer to another city after you start treatment in our practice we will refer you to another orthodontist that has a compatible treatment philosophy with our office. If you have paid your orthodontic fees in advance our office will return all unearned orthodontic fees. The amount of your refund will be determined as follows. Startup costs shall include, but may not be limited to, initial evaluation of orthodontic problems, diagnostic records, case treatment plan, formulation of treatment protocol, appliance fabrication, laboratory procedures, correspondence with your general dentist and other doctors as required. The fees charged for these services are usually a minimum of $1800. The minimum start up fees for Invisalign therapy is $3600 due to initial laboratory fees. Active orthodontic treatment is determined by the number of months you are under our care. You may not have a scheduled appointment every month; however, some months may require multiple appointments. You will be charged a minimum of $150 each month which may or may not be the same as your monthly payment plan. In an effort to make our orthodontic fees affordable you may have paid a smaller down payment and make larger monthly payments. We often give case fee discounts that may or may not be honored if you transfer before completion of your contract with our practice. There is also a records duplication fee of $50 due at the time of transfer. Hopefully you will not be transferred in the middle of your treatment. Many of our patients make arrangements to commute back to our office allowing us to finish the treatment. We can extend your visits to 12 week or more intervals to accommodate your commuting schedule. Clear aligner patients in most cases may elect to continue their treatments until completion and the final retainers can be mailed to you. If you have any chance of being transferred within 12 months of initiating treatment, it may be more prudent to postpone your orthodontic treatment until you relocate. |
*HIPAA
Compliant Codes pursuant to American Dental Association (ADA) Current
Dental Terminology (CDT). Fees subject to change without notice. |
our
doctor | for children | for
adults | dental care | about
braces | terminology | when
to start | locations | ortho
info | quicksmile |