COVERAGE · IDAHOSHEET 13 / 51

Idaho, measured.

2,372 licensed dental providers on record, refreshed monthly from the federal registry. Idaho publishes no fee-for-service dental schedule: every dental service is carved out to the statewide Idaho Smiles managed care program, so this sheet carries no Medicaid floors, modeled bands only (view the source document). Practice costs index at 0.943 against the 1.000 national baseline.

FFS SCHEDULE NONE PUBLISHED · DELIVERY MANAGED CARE Modeled bands only
2,372Licensed providers
0Medicaid fee rows
0.943Geo cost index / 1.000
n/aNo published floors
FEE SPECTRUM25 BENCHMARK CDT CODES

The Idaho fee table

ProcedureMedicaid floorInsurer typicalPrivate-pay p50Private-pay p90
Diagnostic
Routine checkup (existing patient)No published floor$41$57$88
Comprehensive exam (new patient)No published floor$68$94$146
Full-mouth X-ray seriesNo published floor$109$151$219
Bitewing X-rays (set of 4)No published floor$48$66$96
Panoramic X-rayNo published floor$95$132$191
Emergency
Emergency visit for pain reliefNo published floor$99$137$212
Endodontics
Root canal, front toothNo published floor$645$896$1,389
Root canal, molarNo published floor$869$1,207$1,871
Implants
Dental implant placementNo published floor$1,392$1,933$2,996
Oral surgery
Simple tooth extractionNo published floor$132$184$285
Surgical tooth extractionNo published floor$224$311$482
Orthodontics
Full braces treatment, adolescentNo published floor$3,870$5,375$7,256
Periodontics
Deep cleaning below gumline (per quadrant)No published floor$173$240$372
Ongoing gum maintenance visitNo published floor$109$151$234
Preventive
Adult teeth cleaningNo published floor$71$99$153
Child teeth cleaningNo published floor$54$75$116
Fluoride varnish treatmentNo published floor$34$47$73
Protective tooth sealantNo published floor$37$52$81
Restorative
Metal filling (1 surface)No published floor$105$146$226
Tooth-colored filling, front toothNo published floor$132$184$285
Tooth-colored filling, back tooth (1 surface)No published floor$143$198$307
Tooth-colored filling, back tooth (2 surfaces)No published floor$170$236$366
Ceramic crownNo published floor$950$1,320$2,046
Porcelain-on-metal crownNo published floor$780$1,084$1,680
Crown foundation buildupNo published floor$204$283$439

Floor. None. Idaho carves all dental services, for children and adults, out of fee-for-service into the statewide Idaho Smiles managed care program, administered by MCNA Dental. No FFS non-facility dental fee schedule is published, so every row above reads "No published floor." View the state's dental program documentation.

Bands. Modeled: the national median billed charge for each procedure, scaled by the Idaho geographic cost index (0.943 against a 1.000 national baseline), with the insurer-typical amount modeled at roughly 72 percent of area billed charges. Estimates, not quotes.

HOW TO READ IT

Reading this table

The Medicaid floor is the exact fee on the state schedule: the lowest rate a practice accepts for that procedure, and the anchor of the revenue spectrum. Insurer typical models what a commercial plan tends to allow, about 72 percent of area billed charges. Private-pay p50 and p90 are modeled billed-charge bands: the national median scaled by the state cost index, and the top of the usual range. Where a practice actually lands depends on its payer mix. The floor is owned data; the bands are estimates.

CROSS REFERENCE
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