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Fee Schedule

The prices listed are the total cost for the according procedure. There are no surprise costs

CODE
PROCEDURE
WHAT YOU'LL PAY WITH UFT DIRECT ACCESS
TYPICAL CHARGE (WITHOUT UFT DA)
SAVINGS
D0150
Comprehensive Oral Examination
$45
$120
$75
D0210
X-Rays Full Mouth
$50
$187
$137
D0220
Periapical X-Ray First Film
$6
$41
$35
D0240
Occlusal Film
$15
$57
$42
D0270
X-Ray 1 Bitewing
$6
$41
$35
D0330
Panoamic Film
$50
$160
$110
D1110
Prophylaxis
$45
$101
$56
D1120
Prophylaxis - Child
$45
$73
$28
D1351
Sealant
$30
$61
$31
D1510
Space Maintainer - Fixed
$300
$442
$142
D2140
Amalgam - One Surface - Permanent or Primary
$55
$200
$145
D2150
Amalgam - Two Surfaces - Permanent or Primary
$65
$251
$186

 UFT Direct Access Membership Plan 2023. All rights reserved.

 

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Please remember that this is a dental discount plan. You are responsible for any and all charges incurred by you and/or your dependents. UFT Direct Access will not reimburse you or your dentist for any of these charges. Please discuss your treatment plan and charges with your dentist prior to starting any work. You should exercise the same care and apply the same criteria in selecting a participating dentist that you would when selecting a non-participating dentist.

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Disclosure: This discount plan is not insurance and is not intended as a substitute for insurance. The plan does not meet minimum creditable coverage requirements under state or federal law and is not a qualified Health Plan under the Affordable Care Act. The plan provides discounts at participating providers on certain dental services. The range of discounts will vary depending on the type of provider and the dental services received. Members are obligated to pay the provider the entire amount of the discounted rate for services at the point of service. The plan does not pay providers for services provided to members. The discount plan organization is SIDS, 303 Merrick Road, Ste. 300, Lynbrook, NY, 11563, 866-679-7437, info@uftdirectaccess.com. Service Area: This plan is only available to residents of New Jersey And New York, and is not currently available to residents of any other jurisdiction. Participating providers and discounted fees are subject to change without notice and are not available in all areas. The discount plan organization has no liability for providing or guaranteeing dental services or the quality of dental services rendered. Membership and activation fees apply. The plan is governed by the member agreement provided at activation.

 

This web site is provided for information and education purposes only. No doctor/patient relationship is established by your use of this site. No diagnosis or treatment is being provided. The information contained here should be used in consultation with a doctor of your choice. No guarantees or warranties are made regarding any of the information contained within this web site. This web site is not intended to offer specific medical, dental or surgical advice to anyone. Further, this website and SIDS take no responsibility for web sites hyper-linked To and or by this site and such hyperlinking does not imply any relationships or endorsements of the linked sites.

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