COVERAGE · WEST VIRGINIASHEET 49 / 51

West Virginia, measured.

1,594 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 April 1, 2026 (view the source document). Practice costs index at 0.958 against the 1.000 national baseline.

EFFECTIVE APRIL 1, 2026 · FLOORS 23 OF 25 CODES Official schedule on file
1,594Licensed providers
23Medicaid fee rows
0.958Geo cost index / 1.000
$23.47 to $2,874.76Floor range
FEE SPECTRUM25 BENCHMARK CDT CODES

The West Virginia fee table

ProcedureMedicaid floorInsurer typicalPrivate-pay p50Private-pay p90
Diagnostic
Routine checkup (existing patient)$29.33$41$57$88
Comprehensive exam (new patient)$41.07$69$96$149
Full-mouth X-ray series$88$110$153$222
Bitewing X-rays (set of 4)$43.41$48$67$97
Panoramic X-ray$78.62$96$134$194
Emergency
Emergency visit for pain reliefNo published floor$100$139$215
Endodontics
Root canal, front tooth$475.21$655$910$1,410
Root canal, molar$739.22$883$1,226$1,900
Implants
Dental implant placementNo published floor$1,414$1,964$3,044
Oral surgery
Simple tooth extraction$93.87$135$187$290
Surgical tooth extraction$152.54$228$316$490
Orthodontics
Full braces treatment, adolescent$2,874.76$3,932$5,461$7,372
Periodontics
Deep cleaning below gumline (per quadrant)$173.66$176$244$378
Ongoing gum maintenance visit$64$110$153$237
Preventive
Adult teeth cleaning$64.54$73$101$157
Child teeth cleaning$46.93$55$77$119
Fluoride varnish treatment$23.47$35$48$74
Protective tooth sealant$35.20$38$53$82
Restorative
Metal filling (1 surface)$85.66$107$148$229
Tooth-colored filling, front tooth$99.74$135$187$290
Tooth-colored filling, back tooth (1 surface)$109.12$145$201$312
Tooth-colored filling, back tooth (2 surfaces)$133.76$173$240$372
Ceramic crown$745.09$966$1,341$2,079
Porcelain-on-metal crown$745.09$793$1,102$1,708
Crown foundation buildup$164.27$207$287$445

Floor. Official West Virginia Medicaid fee-for-service dental schedule, effective April 1, 2026. View the source document.

Bands. Modeled: the national median billed charge for each procedure, scaled by the West Virginia geographic cost index (0.958 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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