COVERAGE · MINNESOTASHEET 24 / 51

Minnesota, measured.

7,228 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 May 11, 2026 (view the source document). Practice costs index at 0.985 against the 1.000 national baseline.

EFFECTIVE MAY 11, 2026 · FLOORS 22 OF 25 CODES Official schedule on file
7,228Licensed providers
22Medicaid fee rows
0.985Geo cost index / 1.000
$24.20 to $537.37Floor range
FEE SPECTRUM25 BENCHMARK CDT CODES

The Minnesota fee table

ProcedureMedicaid floorInsurer typicalPrivate-pay p50Private-pay p90
Diagnostic
Routine checkup (existing patient)$24.20$42$59$91
Comprehensive exam (new patient)$31.54$71$98$152
Full-mouth X-ray series$76.73$114$158$229
Bitewing X-rays (set of 4)$32.29$50$69$100
Panoramic X-ray$70.67$99$138$200
Emergency
Emergency visit for pain relief$40.37$103$143$222
Endodontics
Root canal, front tooth$353.53$674$936$1,451
Root canal, molar$537.37$908$1,261$1,955
Implants
Dental implant placementNo published floor$1,454$2,019$3,129
Oral surgery
Simple tooth extraction$88.51$138$192$298
Surgical tooth extraction$121.20$234$325$504
Orthodontics
Full braces treatment, adolescent$144.72$4,042$5,614$7,579
Periodontics
Deep cleaning below gumline (per quadrant)$170.58$181$251$389
Ongoing gum maintenance visit$70.67$114$158$245
Preventive
Adult teeth cleaning$52.51$74$103$160
Child teeth cleaning$36.31$57$79$122
Fluoride varnish treatment$27.72$35$49$76
Protective tooth sealant$34.25$39$54$84
Restorative
Metal filling (1 surface)$64.49$110$153$237
Tooth-colored filling, front tooth$72.67$138$192$298
Tooth-colored filling, back tooth (1 surface)$64.49$149$207$321
Tooth-colored filling, back tooth (2 surfaces)$82.47$177$246$381
Ceramic crownNo published floor$993$1,379$2,137
Porcelain-on-metal crownNo published floor$816$1,133$1,756
Crown foundation buildup$151.49$213$296$459

Floor. Official Minnesota Medicaid fee-for-service dental schedule, effective May 11, 2026. View the source document.

Bands. Modeled: the national median billed charge for each procedure, scaled by the Minnesota geographic cost index (0.985 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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