Thank you for considering us for your oral surgery care!

Amount of Coverage: If you are using insurance, it’s very difficult to know what your expected out of pocket is without more information. We would need to know what percentage of the insurance/negotiated fee they cover, which is determined by your group number. It’s all very individualized, but in general, the most common coverage amounts we have seen historically across all plans are as followed:

 - 80-100% coverage for diagnostics (like X-rays, Consults, Exams, etc.).

 - 50-80% for Surgery and Anesthesia ( Extractions, sedations, biopsies, etc.)

 - 0-50% for implants and bone grafting procedures. 

The only way to know the amount of coverage is to call your insurance company’s customer service number and ask them.

We can definitely give you a MAXIMUM cost you would ever see with us (which is just the sum of the insurance negotiated rates) without taking any consideration for what % your insurance will contribute to.  It’s a sticker shock to see them, which is why we don’t like to send them, but just know it’s extremely unlikely that your insurance wouldn’t pay anything towards the responsibility. 

Extraction Estimates: Another consideration for extractions, is that wisdom teeth rates vary tremendously due to how impacted they are (or aren’t), so without an X-Ray to submit to insurance, we don’t know what charge they will consider. 

The Contracted Rates per Extraction at our office are as followed: please note that these are for the extractions only, and do not factor in the cost of any exams, X-rays, or anesthesia options.   

 Aetna: $300-600 per tooth 

 BCBS: $200-450 per tooth

 Delta: $300-650 per tooth

 Metlife PDP+ Plans: $450-950 per tooth

Some Guardian Plans:   $450-950 per tooth

Some Principle Plans: $450-950 per tooth

  Some United Plans: $450-950 per tooth

  Out of Network: $500-1,000 per tooth

Lastly, another consideration are policy limitations; Generally plans only pay out $1000-3000 per calendar year per patient for all claims; if your insurance funds for the year are already exhausted, the patient has to make up their difference until the contracted/negotiated amounts are satisfied, unfortunately. Also, Most plans limit the number of diagnostic services in a certain amount of time; for example, they might only pay for an X-Ray if you haven’t had one in the last two or three years, only allow 2 exams per year, etc. 

But Dr. Cappetta is very reasonable, and will try to help you out as best as he can to reduce your out of pocket costs.  The best thing to do is schedule a consultation with him, and our insurance team will take care of the rest. We try our best to have NO surprise costs, and we give treatment plans for all procedures. We also offer no-interest payment plans for any out of pocket costs exceeding $500.