COVERAGE · MICHIGANSHEET 23 / 51

Michigan, measured.

13,459 licensed dental providers on record, refreshed monthly from the federal registry. The Medicaid floors below come from the official state fee-for-service schedule, published without a stated effective date; figures reflect the current edition (view the source document). Practice costs index at 0.989 against the 1.000 national baseline.

EFFECTIVE NOT STATED · FLOORS 25 OF 25 CODES Official schedule on file
13,459Licensed providers
25Medicaid fee rows
0.989Geo cost index / 1.000
$32.29 to $1,775Floor range
FEE SPECTRUM25 BENCHMARK CDT CODES

The Michigan fee table

ProcedureMedicaid floorInsurer typicalPrivate-pay p50Private-pay p90
Diagnostic
Routine checkup (existing patient)$33.99$42$59$91
Comprehensive exam (new patient)$54.14$71$99$153
Full-mouth X-ray series$90$114$158$229
Bitewing X-rays (set of 4)$40.92$50$69$100
Panoramic X-ray$81.29$99$138$200
Emergency
Emergency visit for pain relief$79.43$103$143$222
Endodontics
Root canal, front tooth$499.43$677$940$1,457
Root canal, molar$742.86$912$1,266$1,962
Implants
Dental implant placement$1,434.90$1,459$2,027$3,142
Oral surgery
Simple tooth extraction$101$139$193$299
Surgical tooth extraction$181.86$235$326$505
Orthodontics
Full braces treatment, adolescent$1,775$4,059$5,637$7,610
Periodontics
Deep cleaning below gumline (per quadrant)$170$181$252$391
Ongoing gum maintenance visit$105.29$114$158$245
Preventive
Adult teeth cleaning$62.14$75$104$161
Child teeth cleaning$46.71$57$79$122
Fluoride varnish treatment$32.29$35$49$76
Protective tooth sealant$33.71$39$54$84
Restorative
Metal filling (1 surface)$77.14$110$153$237
Tooth-colored filling, front tooth$97.39$139$193$299
Tooth-colored filling, back tooth (1 surface)$113.57$150$208$322
Tooth-colored filling, back tooth (2 surfaces)$147$178$247$383
Ceramic crown$817.57$997$1,385$2,147
Porcelain-on-metal crown$744.14$819$1,137$1,762
Crown foundation buildup$192.29$214$297$460

Floor. Official Michigan Medicaid fee-for-service dental schedule, current edition, no stated effective date. View the source document.

Bands. Modeled: the national median billed charge for each procedure, scaled by the Michigan geographic cost index (0.989 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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