COVERAGE · OHIOSHEET 36 / 51

Ohio, measured.

11,729 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 January 1, 2025 (view the source document). Practice costs index at 0.961 against the 1.000 national baseline.

EFFECTIVE JANUARY 1, 2025 · FLOORS 22 OF 25 CODES Official schedule on file
11,729Licensed providers
22Medicaid fee rows
0.961Geo cost index / 1.000
$29.48 to $1,192.46Floor range
FEE SPECTRUM25 BENCHMARK CDT CODES

The Ohio fee table

ProcedureMedicaid floorInsurer typicalPrivate-pay p50Private-pay p90
Diagnostic
Routine checkup (existing patient)$33.56$42$58$90
Comprehensive exam (new patient)$50.35$69$96$149
Full-mouth X-ray series$117.90$111$154$223
Bitewing X-rays (set of 4)$39.30$48$67$97
Panoramic X-ray$88.52$97$135$196
Emergency
Emergency visit for pain reliefNo published floor$100$139$215
Endodontics
Root canal, front tooth$473.22$657$913$1,415
Root canal, molar$724.31$886$1,230$1,906
Implants
Dental implant placementNo published floor$1,418$1,970$3,054
Oral surgery
Simple tooth extraction$113.36$135$187$290
Surgical tooth extraction$113.36$228$317$491
Orthodontics
Full braces treatment, adolescent$1,192.46$3,944$5,478$7,395
Periodontics
Deep cleaning below gumline (per quadrant)$188.62$176$245$380
Ongoing gum maintenance visit$67.07$111$154$239
Preventive
Adult teeth cleaning$65.22$73$101$157
Child teeth cleaning$38.22$55$77$119
Fluoride varnish treatment$29.48$35$48$74
Protective tooth sealant$43.23$38$53$82
Restorative
Metal filling (1 surface)$78.60$107$149$231
Tooth-colored filling, front tooth$97.86$135$187$290
Tooth-colored filling, back tooth (1 surface)$97.86$145$202$313
Tooth-colored filling, back tooth (2 surfaces)$103.19$173$240$372
Ceramic crown$816.55$968$1,345$2,085
Porcelain-on-metal crownNo published floor$796$1,105$1,713
Crown foundation buildup$146.27$207$288$446

Floor. Official Ohio Medicaid fee-for-service dental schedule, effective January 1, 2025. View the source document.

Bands. Modeled: the national median billed charge for each procedure, scaled by the Ohio geographic cost index (0.961 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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