COVERAGE · NORTH CAROLINASHEET 34 / 51

North Carolina, measured.

12,203 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 October 1, 2025 (view the source document). Practice costs index at 0.955 against the 1.000 national baseline.

EFFECTIVE OCTOBER 1, 2025 · FLOORS 22 OF 25 CODES Official schedule on file
12,203Licensed providers
22Medicaid fee rows
0.955Geo cost index / 1.000
$16.78 to $856.10Floor range
FEE SPECTRUM25 BENCHMARK CDT CODES

The North Carolina fee table

ProcedureMedicaid floorInsurer typicalPrivate-pay p50Private-pay p90
Diagnostic
Routine checkup (existing patient)$26.96$41$57$88
Comprehensive exam (new patient)$46.65$69$96$149
Full-mouth X-ray series$75.08$110$153$222
Bitewing X-rays (set of 4)$33.55$48$67$97
Panoramic X-ray$61.95$96$134$194
Emergency
Emergency visit for pain relief$44.52$99$138$214
Endodontics
Root canal, front tooth$296.52$653$907$1,406
Root canal, molar$428.62$880$1,222$1,894
Implants
Dental implant placementNo published floor$1,410$1,958$3,035
Oral surgery
Simple tooth extraction$66.44$134$186$288
Surgical tooth extraction$114.21$227$315$488
Orthodontics
Full braces treatment, adolescent$856.10$3,920$5,444$7,349
Periodontics
Deep cleaning below gumline (per quadrant)$105.13$176$244$378
Ongoing gum maintenance visit$51.85$110$153$237
Preventive
Adult teeth cleaning$39.83$72$100$155
Child teeth cleaning$28.46$55$76$118
Fluoride varnish treatment$16.78$35$48$74
Protective tooth sealant$29.89$38$53$82
Restorative
Metal filling (1 surface)$78.12$107$148$229
Tooth-colored filling, front tooth$68.90$134$186$288
Tooth-colored filling, back tooth (1 surface)$83.60$145$201$312
Tooth-colored filling, back tooth (2 surfaces)$110.92$172$239$370
Ceramic crownNo published floor$963$1,337$2,072
Porcelain-on-metal crownNo published floor$791$1,098$1,702
Crown foundation buildup$102.73$206$286$443

Floor. Official North Carolina Medicaid fee-for-service dental schedule, effective October 1, 2025. View the source document.

Bands. Modeled: the national median billed charge for each procedure, scaled by the North Carolina geographic cost index (0.955 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
Explore any market anywhere in North Carolina. Three free explorations a day, no card. An exploration runs in 60 to 90 seconds: competition, demand, referral network, and every figure against its benchmark.