COVERAGE · NEW JERSEYSHEET 31 / 51

New Jersey, measured.

12,531 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 1.086 against the 1.000 national baseline.

EFFECTIVE NOT STATED · FLOORS 25 OF 25 CODES Official schedule on file
12,531Licensed providers
25Medicaid fee rows
1.086Geo cost index / 1.000
$9.90 to $550Floor range
FEE SPECTRUM25 BENCHMARK CDT CODES

The New Jersey fee table

ProcedureMedicaid floorInsurer typicalPrivate-pay p50Private-pay p90
Diagnostic
Routine checkup (existing patient)$16.50$47$65$101
Comprehensive exam (new patient)$16.50$78$109$169
Full-mouth X-ray series$28.60$125$174$252
Bitewing X-rays (set of 4)$9.90$55$76$110
Panoramic X-ray$17.33$109$152$220
Emergency
Emergency visit for pain relief$11$113$157$243
Endodontics
Root canal, front tooth$162.80$743$1,032$1,600
Root canal, molar$271.70$1,001$1,390$2,154
Implants
Dental implant placement$550$1,603$2,226$3,450
Oral surgery
Simple tooth extraction$35.20$153$212$329
Surgical tooth extraction$36.30$258$358$555
Orthodontics
Full braces treatment, adolescent$542.30$4,457$6,190$8,356
Periodontics
Deep cleaning below gumline (per quadrant)$41.25$199$277$429
Ongoing gum maintenance visit$37.40$125$174$270
Preventive
Adult teeth cleaning$18.70$82$114$177
Child teeth cleaning$50$63$87$135
Fluoride varnish treatment$36.30$39$54$84
Protective tooth sealant$41$43$60$93
Restorative
Metal filling (1 surface)$35.20$121$168$260
Tooth-colored filling, front tooth$39.05$153$212$329
Tooth-colored filling, back tooth (1 surface)$35.20$164$228$353
Tooth-colored filling, back tooth (2 surfaces)$41.80$196$272$422
Ceramic crown$306.90$1,094$1,520$2,356
Porcelain-on-metal crown$306.90$899$1,249$1,936
Crown foundation buildup$53.90$235$326$505

Floor. Official New Jersey 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 New Jersey geographic cost index (1.086 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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