COVERAGE · ILLINOISSHEET 14 / 51

Illinois, measured.

17,083 licensed dental providers on record, refreshed monthly from the federal registry. The Medicaid floors below come from the official state fee-for-service schedule, effective January 1, 2026 (view the source document). Practice costs index at 1.023 against the 1.000 national baseline.

EFFECTIVE JANUARY 1, 2026 · FLOORS 24 OF 25 CODES Official schedule on file
17,083Licensed providers
24Medicaid fee rows
1.023Geo cost index / 1.000
$19.94 to $900Floor range
FEE SPECTRUM25 BENCHMARK CDT CODES

The Illinois fee table

ProcedureMedicaid floorInsurer typicalPrivate-pay p50Private-pay p90
Diagnostic
Routine checkup (existing patient)$28$44$61$95
Comprehensive exam (new patient)$26.08$73$102$158
Full-mouth X-ray series$35.52$118$164$238
Bitewing X-rays (set of 4)$19.94$52$72$104
Panoramic X-ray$28$103$143$207
Emergency
Emergency visit for pain relief$55$107$148$229
Endodontics
Root canal, front tooth$158.22$700$972$1,507
Root canal, molar$234.67$942$1,309$2,029
Implants
Dental implant placementNo published floor$1,510$2,097$3,250
Oral surgery
Simple tooth extraction$53.55$143$199$308
Surgical tooth extraction$78.57$243$338$524
Orthodontics
Full braces treatment, adolescent$900$4,198$5,831$7,872
Periodontics
Deep cleaning below gumline (per quadrant)$122$188$261$405
Ongoing gum maintenance visit$67$118$164$254
Preventive
Adult teeth cleaning$48.38$77$107$166
Child teeth cleaning$43.05$59$82$127
Fluoride varnish treatment$27.30$37$51$79
Protective tooth sealant$37.80$40$56$87
Restorative
Metal filling (1 surface)$36.40$114$159$246
Tooth-colored filling, front tooth$52.18$143$199$308
Tooth-colored filling, back tooth (1 surface)$36.40$155$215$333
Tooth-colored filling, back tooth (2 surfaces)$56.82$184$256$397
Ceramic crown$272.83$1,031$1,432$2,220
Porcelain-on-metal crown$272.83$847$1,176$1,823
Crown foundation buildup$67.34$221$307$476

Floor. Official Illinois Medicaid fee-for-service dental schedule, effective January 1, 2026. View the source document.

Bands. Modeled: the national median billed charge for each procedure, scaled by the Illinois geographic cost index (1.023 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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