It might pay to shop around to compare prices because not all dentists charge the same amount for specific services unless they participate as an in-network provider with your PPO dental insurance plan.
The most affordable dentist will always be the in-network provider with your PPO dental plan because the insurance company negotiates fees in advance and has the most bargaining leverage.
But what if you are uninsured? How do you know which provider charges the lowest prices?
Online dental cost estimators can provide valid comparative information. You can proceed with treatment knowing you are not overpaying, or you can use the data to negotiate lower fees.
Dental Prices Without Insurance
Dentists often charge different prices for the same procedure to uninsured patients because they have no contracted fee schedules to follow. Market forces (competition, area demographics, practice lifecycle) dictate their cost structure in these cases.
Dental financial assistance programs help uninsured patients only in rare circumstances. Meanwhile, everyone can comparison shop to find the most affordable provider.
Dental Cost Estimator
Some insurance companies publish online dental cost estimators, making it easier for patients without coverage to compare quoted prices for specific procedures. Since dentists often charge different fees to uninsured patients, it helps to know that you are getting a reasonable price.
Enter your zip code and treatment type to instantly get a range of retail costs compared to what your local provider wants to charge. If the numbers differ from the quoted figure, you can negotiate a lower price.
Cheapest Dentist
Because dentists often charge different prices to uninsured patients, shopping for the cheapest provider could save you money. However, many offices do not post their fee schedules, making comparisons tricky.
However, we can all think like businesspeople while doing simple detective work. The offices charging the lowest prices often need to attract new patients! Therefore, look for some of these clues.
- Check their online appointment scheduler to see how many slots are available. Open times indicate a shortage of customers.
- Look for indications that ownership has recently changed, such as signs with a new dentist’s name. They may need to boost their income quickly to repay the acquisition loan.
- Drive past the location during their posted business hours and count the cars in the parking lot and the number of patients sitting in the waiting room area.
- Do a Google search for the type of service needed and look at the paid ads at the top from local dentists advertising for new patients.
Dental Prices With Insurance
When comparing dental prices with insurance, the provider status with your plan is an enormous differentiator. In-network dentists charge a much lower negotiated rate than those who do not participate.
In-Network Dentists
All dentists participating in the network with your PPO dental insurance plan charge the same amount for every covered procedure. The provider signs a contract with the issuing company to accept the uniform “Allowed Amount” as payment in full.
In other words, patients do not need to shop around comparing prices because the insurance company has already negotiated the lowest possible rate for specified treatment.
For instance, dentists who accept adult Medicaid agree not to balance bill patients after receiving reimbursement from the public insurance program for low-income families.
Search online for the “Find a Dentist” tool on your insurance company’s website to find a listing of local providers in-network with your plan. Pick the one closest to home since they all have a contractual obligation to charge the same price: the Allowed Amount.
Out-of-Network Dentists
Dentists who are out-of-network with your insurance plan frequently charge different prices because they did not sign a contract agreeing to the “Allowed Amount” as full payment – even if they accept payment from your insurer.
Out-of-network dentists can charge more than insurance allows. Therefore, your choice of words is crucial, and you will want to confirm these details before commencing treatment.
- Accepts most insurance means that they will gladly cash the benefit check paid by the insurance company and then bill you for the remaining balance without discounting their prices.
- Participating in-network with your insurance means they will discount their prices to meet the uniform “Allowed Amount” and will only balance bill the cost-sharing components: deductible, copayment, coinsurance, etc.
