Dental Wisdom: Dental Provider Network Discounts verses Dental Insurance

Posted on Mar 15, 2021

Dental insurance is very coveted by many people who gladly pay hundreds or thousands of dollars per year. Many more wish they could afford or their employer would provide them with good dental insurance. What most people don’t understand is the majority of the benefit of dental insurance isn’t what the insurance company pays; it’s what the dental provider agreed to in substantial discounts. The dental insured doesn’t know the difference and they believe their dental insurance pays up to 60% of their serious dental procedures. This is incorrect.

From a lifetime of experience here’s some shared wisdom. Dental insurance policies aren’t worth the cost. It’s also one of the only insurance plans you actually have to use regularly to get any value from it. And up to 30% of your premium is paying commission to the agent and profit to the company. Another 30% of the cost is paying for the dental provider network (deep discounts) and what remains of your premium cover claims for the free X-Ray, office visits, cleanings and fillings. If you don’t use these services then you lose them and those extra unpaid benefits become extra profit to the dental insurance carrier.

Most dental plans will offer free X-Rays, free cleaning, fillings and office visits; but this is the extent of most dental insurance plans.  The average policy will run $25 to $40 or more a month. You actually have to take advantage of every benefit they offer to  break even on the cost of dental coverage. The dental insurance carriers depend on the fact that most people avoid the dentist until they have a toothache.

The dental insurance free X-Ray is like a $19.95 oil change loss leader. It’s designed to get you into the store so they can pop the hood and find all the other profitable repairs that also need to be done. And no dental office will let you get by with just a free regular cleaning. If you have any gum/tooth pockets greater than a 3 in any quadrant you will become a lifetime deep cleaning “periodontal maintenance” customer.  Cha-Ching.

The real heavy dollar discounts are not coming from dental insurance, they’re coming from pre-negotiated dental insurance provider network discounts. A $1,300 to $1,500 root canal can be discounted down to just $650 which simply means an Endodontist who specializes in root canals has agreed to do them for $650 instead of their normal $1,300 walk-in off the street price. Never, ever, ever walk in off the street and buy a root canal or other serious dental work without taking advantage of the network discounts.

I pay $125 a year for the Aetna Dental Access plan which allows me to buy into the Aetna Dental Provider Network and all their dental practice negotiated discounts. My card says Aetna Dental Access with my name and a group number and is accepted like any other dental insurance plan.  Another benefit of this plan is no preexisting condition limitations. You can enroll, download a card and two or three days later start serious dental procedures at half off the regular price.

You can’t do this with dental insurance. Most dental insurance doesn’t allow you to enroll and immediately start serious dental work. You will almost always have a 6 to 12 month waiting period even for the discounted network rates. So you’re forced to wait up to a year just to get the discounted network rate. Which means they really want people who won’t use the policy and forfeit the free benefits as extra profit.

The reason I share this is because I was at my dentist’s office this morning early and was told in 30 years I’m only the second patient they’ve seen that bought into the Aetna dental network discounts. I knew I needed to write a blog post.

Here’s the General Dentist recommendation for toothache pain until you can get to an office or schedule with an Endodontist. “Take 3 – 200 mg Ibuprofen tablets every 8 hours for pain. In the 600 mg dosage it also treats the inflammation.” My issue was a stress crack in a molar allowing infection to enter the root causing pain, infection and inflammation. No more ice breaking, almonds, or anything hard, it’s too expensive and painful to save teeth.

Experience using the plan for an Endodontist

The Aetna Dental Access plan works best at a General Dentist’s office. A root canal for a molar tooth at an Endodontist’s office I found can cost any of several tier prices the Endodontist can sign up for: lowest tier $766, next higher tier $861, highest tier $1040 so you have to check the site for the actual negotiated discount by dentist and verify the rate before appointment.  I discovered the lower the price for a root canal the more 1 and 2 star angry reviews. I also discovered many will charge a $181 evaluation charge on top of a $1,040 root canal so you have to ask questions.

Example: a $766 root canal Endodontist had 3 stars (half 5 star happy half 1 star angry), and from $861 to $1,040 will be 4 stars, and 5 star Endodontists don’t offer any discounts at all and can cost up to $1,595. I did verify that there weren’t any extra evaluation, x-ray, or odd charges on top of the $1,595 root canal. After a day of research (in pain) and trying to make an immediate appointment I went with a 5 star $1,595 Endodontist who completed the root canal in 30 minutes who was not in the Aetna network.

After the root canal the Endodontist recommends 3 – 200 mg Ibuprofen tablets every 4 to 6 hours for pain and a Z Pack antibiotic.

Aetna Dental Access

Discounted fees are Sample Savings based on General Dentist Fees. Dental Fees for this program vary by Dentist.

 Procedure Description ADA Code Price Without Plan1 Sample Price with Plan Savings Percentage
Routine 6 Month Check-Up D0120 $55 $26 53%
In Depth Check-Up D0150 $93 $38 59%
Full Mouth X-Rays D0210 $149 $67 55%
bitewing – single radiographic image D0270 $30 $12 60%
Four Bitewing X-Rays D0274 $69 $30 57%
Panoramic Film D0330 $122 $52 57%
Adult Teeth Cleaning D1110 $96 $48 50%
Child Teeth Cleaning D1120 $75 $35 53%
Protective Sealant / Tooth D1351 $60 $30 50%
1 Surface Silver Filling for Primary or Permanent Tooth D2140 $170 $73 57%
1 Surface White Filling for U or L Front Tooth D2330 $185 $87 53%
Single Crown – Porcelain on High Noble Metal D2750 $1,216 $735 40%
Single Crown – Porcelain on Noble Metal D2752 $1,150 $711 38%
Core Build-Up With Pins D2950 $306 $133 57%
Labial veneer (resin laminate) – direct D2960 $715 $244 66%
Labial veneer (porcelain laminate) – indirect D2962 $1,461 $539 63%
Root Canal Treatment – Front Tooth D3310 $975 $429 56%
Root Canal Treatment – Bicuspid D3320 $1,065 $472 56%
Root Canal Treatment – Molar D3330 $1,295 $663 49%
Bone replacement graft – retained natural tooth – first site in quadrant D4263 $710 $289 59%
Perio Scaling and Root Planing (Per Quadrant) D4341 $285 $147 48%
Regular Cleaning Following Periodontic Procedure D4910 $155 $64 59%
Full Upper Denture D5110 $1,779 $850 52%
add clasp to existing partial denture D5660 $275 $164 40%
surgical placement of implant body: endosteal implant D6010 $2,250 $1,532 32%
abutment supported cast metal crown (predominantly base metal) D6063 $1,407 $568 60%
Implant supported crown high noble alloys D6067 $1,250 $856 32%
Tooth Replacement Part of Permanent Bridge D6210 $1,172 $650 45%
Single Tooth Removal – Simple Extraction D7140 $186 $72 61%
Extraction – Impacted Wisdom Tooth (Soft Tissue) D7220 $365 $153 58%
Extraction – Impacted Wisdom Tooth (Partial Bony) D7230 $480 $219 54%
external bleaching – per tooth D9973 $185 $24 87%
internal bleaching – per tooth D9974 $345 $111 68%


Discount chart from:


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