COVERAGE · MISSOURISHEET 26 / 51

Missouri, measured.

6,147 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 June 8, 2026 (view the source document). Practice costs index at 0.962 against the 1.000 national baseline.

EFFECTIVE JUNE 8, 2026 · FLOORS 24 OF 25 CODES Official schedule on file
6,147Licensed providers
24Medicaid fee rows
0.962Geo cost index / 1.000
$36.80 to $1,048.80Floor range
FEE SPECTRUM25 BENCHMARK CDT CODES

The Missouri fee table

ProcedureMedicaid floorInsurer typicalPrivate-pay p50Private-pay p90
Diagnostic
Routine checkup (existing patient)$48.80$42$58$90
Comprehensive exam (new patient)$83.20$69$96$149
Full-mouth X-ray series$123.20$111$154$223
Bitewing X-rays (set of 4)$60$48$67$97
Panoramic X-ray$104.80$97$135$196
Emergency
Emergency visit for pain relief$37.92$100$139$215
Endodontics
Root canal, front tooth$695.20$658$914$1,417
Root canal, molar$956$886$1,231$1,908
Implants
Dental implant placement$373.11$1,420$1,972$3,057
Oral surgery
Simple tooth extraction$93.56$135$188$291
Surgical tooth extraction$138.22$228$317$491
Orthodontics
Full braces treatment, adolescentNo published floor$3,948$5,483$7,402
Periodontics
Deep cleaning below gumline (per quadrant)$238.40$176$245$380
Ongoing gum maintenance visit$125.60$111$154$239
Preventive
Adult teeth cleaning$85.60$73$101$157
Child teeth cleaning$62.40$55$77$119
Fluoride varnish treatment$36.80$35$48$74
Protective tooth sealant$50.40$38$53$82
Restorative
Metal filling (1 surface)$132$107$149$231
Tooth-colored filling, front tooth$155.20$135$188$291
Tooth-colored filling, back tooth (1 surface)$169.60$145$202$313
Tooth-colored filling, back tooth (2 surfaces)$214.40$173$240$372
Ceramic crown$1,048.80$970$1,347$2,088
Porcelain-on-metal crown$1,029.60$796$1,106$1,714
Crown foundation buildup$249.60$208$289$448

Floor. Official Missouri Medicaid fee-for-service dental schedule, effective June 8, 2026. View the source document.

Bands. Modeled: the national median billed charge for each procedure, scaled by the Missouri geographic cost index (0.962 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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