COVERAGE · WASHINGTONSHEET 48 / 51

Washington, measured.

11,575 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, 2026 (view the source document). Practice costs index at 1.071 against the 1.000 national baseline.

EFFECTIVE JANUARY 1, 2026 · FLOORS 24 OF 25 CODES Official schedule on file
11,575Licensed providers
24Medicaid fee rows
1.071Geo cost index / 1.000
$12.42 to $1,432.22Floor range
FEE SPECTRUM25 BENCHMARK CDT CODES

The Washington fee table

ProcedureMedicaid floorInsurer typicalPrivate-pay p50Private-pay p90
Diagnostic
Routine checkup (existing patient)$30.36$46$64$99
Comprehensive exam (new patient)$37.26$77$107$166
Full-mouth X-ray series$48.30$123$171$248
Bitewing X-rays (set of 4)$12.42$54$75$109
Panoramic X-ray$37.26$108$150$218
Emergency
Emergency visit for pain relief$62.10$112$155$240
Endodontics
Root canal, front tooth$351.94$732$1,017$1,576
Root canal, molar$543.11$987$1,371$2,125
Implants
Dental implant placementNo published floor$1,581$2,196$3,404
Oral surgery
Simple tooth extraction$45.73$150$209$324
Surgical tooth extraction$89.70$254$353$547
Orthodontics
Full braces treatment, adolescent$1,432.22$4,396$6,105$8,242
Periodontics
Deep cleaning below gumline (per quadrant)$36.27$197$273$423
Ongoing gum maintenance visit$69$123$171$265
Preventive
Adult teeth cleaning$51.57$81$112$174
Child teeth cleaning$32.17$62$86$133
Fluoride varnish treatment$19.50$39$54$84
Protective tooth sealant$30.93$42$59$91
Restorative
Metal filling (1 surface)$49.74$120$166$257
Tooth-colored filling, front tooth$47.86$150$209$324
Tooth-colored filling, back tooth (1 surface)$49.74$162$225$349
Tooth-colored filling, back tooth (2 surfaces)$66.76$193$268$415
Ceramic crown$560.97$1,079$1,499$2,323
Porcelain-on-metal crown$560.97$887$1,232$1,910
Crown foundation buildup$67.90$231$321$498

Floor. Official Washington Medicaid fee-for-service dental schedule, effective January 1, 2026. View the source document.

Bands. Modeled: the national median billed charge for each procedure, scaled by the Washington geographic cost index (1.071 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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