| Dental check up | Oral Examination | 0 / visit |
| Bitewing Oral Examination + Bitewing X-ray | 1,000 / visit | |
| Consultation + Treatment Plan | 300 – 1,000 / visit Depend on Time for Treatment Plan |
|
| Study model | 2,000 | |
| X-ray | Periapical X-ray | 250 / film |
| Occlusal X-ray | 500 / film | |
| Panoramic X-ray | 1,000 / film | |
| Cephalometric X-ray | 1,000 / film | |
| Panoramic + Cephalometric X-ray | 1,800 | |
| Bitewing X-ray 4 films | 1,000 | |
| CBCT (3D Digital X-Ray) | ||
| Area for Implant | ||
| 1 Quadrant / 1 Tooth | 2,500 | |
| 2 Quadrant | 4,000 | |
| Full Mouth | 7,000 | |
| Area for Others | ||
| 1 Tooth | 2,500 / tooth | |
| Foreign Body | 2,500 / area | |
| TMJ | 2,500 / side | |
| Filling | 1 surface | 800 – 1,500 / tooth |
| 2 – 3 surface | 1,500 – 3,000 / tooth | |
| 4 – 5 surface | 3,000 – 4,500 / tooth | |
| Depend on Size | ||
| Canine esthetic | Full Canine | 5,000 / tooth |
| Half Canine | 2,000 / tooth | |
| Diamond esthetic | 1,000 / unit | |
| Synthetic diamond | 300 / unit | |
| Diastema Closure | 2,000 – 5,000 / tooth Depend on Size |
|
| Veneer | Composite Veneer : 1-4 teeth | 5,000 / tooth |
| Composite Veneer : 5-8 teeth | 4,000 / tooth | |
| Composite Veneer : more than 8 teeth | 3,000 / tooth | |
| Ceramic : 1-6 teeth | 12,000 / tooth | |
| Ceramic : more than 6 teeth | 11,000 / tooth | |
| Composite Veneer Removal | 1,000 / tooth | |
| Ceramic Veneer Removal | 1,500 / tooth | |
| Inlay / Onlay | Ceramic | 18,000 / tooth |
| Gold | 20,000 – 25,000 / tooth Depend on size and weight of gold |
|
| Scaling and polishing | Less than 12 years old | 500 – 1,000 |
| More than 12 years old | 800 – 2,500
Depend on staining and calculus |
|
| Periodontal treatment and oral hygiene instruction | Tooth | 800 – 1,000 / tooth |
| Quadrant | 2,500 – 3,000 / Quadrant | |
| Periodontal Surgery | 8,000 / tooth | |
| Gingival Graft | ||
| 8,000 / tooth | ||
| Root resection and retrograde filling | ||
| 9,000 / tooth | ||
| Hemisection / Root Amputation | ||
| 9,000 / tooth | ||
| Therapeutic Pulpotomy | Anterior tooth | 4,500 / tooth |
| Premolar tooth | 5,500 / tooth | |
| Molar tooth | 7,500 / tooth | |
| Root canal treatment | Anterior tooth | 9,000 / tooth |
| Premolar tooth | 11,000 / tooth | |
| Molar tooth | 15,000 / tooth | |
| Note | ||
| Medication more than 2 visits | 1,000 / visit | |
| Remove root canal filling | 1,000 / root canal | |
| Remove Calcium stone in root canal | 1,500 / tooth | |
| Pintooth removal | ||
| 5,000 / tooth | ||
| Crown removal | 1,500 / tooth | |
| Pintooth | Glass fiber & core | 6,000 / tooth |
| Cosmo post & core | 7,000 / tooth | |
| Composite core | 4,000 / tooth | |
| Non-precious metal | 6,000 / tooth | |
| Palladium | 9,000 / tooth | |
| Semi-precious metal | ||
| – Anterior tooth, Premolar | 10,000 / tooth | |
| – Molar | 12,000 / tooth | |
| Crown / Bridge | All ceramic crown | |
| Zirconia | 16,000 / unit | |
| Porcelain fuse to metal crown | ||
| Non-precious | 10,000 / unit | |
| Semi-precious / Palladium | ||
| Anterior tooth, Premolar | 18,000 / unit | |
| Molar | 20,000 / unit | |
| Hi-precious | ||
| Anterior tooth, Premolar | 22,000 / unit | |
| Molar | 24,000 / unit | |
| Full metal crown | ||
| Non-precious | 10,000 / unit | |
| Semi-precious / Palladium | ||
| Anterior tooth, Premolar | 20,000 / unit | |
| Molar | 22,000 / unit | |
| Hi-precious | ||
| Anterior tooth, Premolar | 24,000 / unit | |
| Molar | 26,000 / unit | |
| Temporary Crown | Acrylic Resin | 3,000 / unit |
| Enamic | 5,000 / unit | |
| Adoro | 6,000 / unit | |
| Repair denture | Self Cure Acrylic Resin | Heat Cure Acrylic Resin | |
| Acrylic base | 1,200 / unit | 1,800 / unit | |
| Tooth denture : 1st tooth | 1,200 | 1,800 | |
| Tooth denture : next tooth | 800 / tooth | 800 / tooth | |
| Reline / Rebase | Self-cured resin | 1,000 / unit |
| Rebase resin | 1,500 – 2,000 / unit | |
| Soft liner | 1,500 / unit | |
| Full denture | COSMO | IVOCLARE | |
| Acrylic base | 26,000 | 36,000 | |
| High impact acrylic base | 30,000 | 40,000 | |
| Metal base | 40,000 | 50,000 | |
| Partial denture | Acrylic base | ||
| Base | 2,200 | ||
| COSMO | IVOCLARE | ||
| Tooth | 800 / tooth | 1,200 / tooth | |
| Flexible base | |||
| Base | 8,000 | ||
| COSMO | IVOCLARE | ||
| Tooth | 800 / tooth | 1,200 / tooth | |
| Metal base | |||
| Metal | 12,000 | ||
| COSMO | IVOCLARE | ||
| Tooth | 800 / tooth | 1,200 / tooth | |
| Esthetic clasp | 1,000 / tooth | ||
| Dental implant (include crown) |
45,000 – 85,000 / tooth Depend on Type of Implant |
|
| Bone graft | 20,000 – 30,000 / area Depend on Size |
|
| Sinus lift and Bone Graft | 40,000 – 50,000 / side Depend on Size |
|
| Extraction permanent tooth | ||
| 1,000 – 1,500 / tooth Depend on Position |
||
| Extraction: surgical removal | 2,000 – 3,500 / tooth Depend on Position |
|
| Wisdom Tooth Removal | Soft Tissue Impaction | 3,000 – 4,000 / tooth |
| Partial Bony Impaction | 4,000 – 6,000 / tooth | |
| Complete Bony Impaction | 6,000 – 8,000 / tooth | |
| Depend on Position | ||
| Gingivoplasty & Gingivectomy | 2,000 – 3,000 / tooth Depend on Position & Size |
|
| Frenectomy | 3,000 / area | |
| Alveoloplasty | 3,000 – 5,000 / Quadrant | |
| Crown lengthening | 6,000 / tooth | |
| Torectomy | 6,000 – 8,000 / arch Depend on Position & Size |
|
| Enucleation | 4,000 – 7,000 / area Depend on Position & Size |
|
| Excision | 2,000 – 5,000 / area Depend on Position & Size |
|
| Autotooth transplantation | ||
| 6,000 – 8,000 / tooth Depend on Socket Preparation |
||
| Surgical uprighting procedure | 4,000 – 5,000
Depend on Position |
|
| Treatment of avulsion ( include etch – wire splint ) | 6,000 / tooth | |
| Artificial eruption | 4,000 – 5,000 / tooth Depend on Position |
|
| Incision and drainage | 1,500 – 2,500 / area Depend on Position & Size |
|
| Wound Sutured | 2,000 – 3,000/ area Depend on Position & Size |
|
| Wound Irrigation | 300 / visit | |
| Resorbable suture | 300 / pack | |
| Hemostatic agent | Surgicel | 500 / pack |
| Gel foam | 100 / pack | |
| Extraction: primary teeth | 500 – 1,000 / tooth | |
| Extraction: primary teeth under topical anesthetic | 200 – 300 / tooth | |
| Pulp treatment | Pulpotomy | 2,000 / tooth |
| Pulpectomy | 2,500 / tooth | |
| Crown on baby tooth | Stainless steel crown / Strip crown | 2,500 / tooth |
| Zirconia crown | 6,000 / tooth | |
| Stainless Steel Crown on permanent tooth | Premolar | 4,000 / tooth |
| Molar | 5,000 / tooth | |
| Filling on deciduous tooth | 1 surface | 800 – 1,500 / tooth |
| 2 – 3 surface | 1,000 – 2,000 / tooth | |
| Depend on Size | ||
| Fluoride protection | 800 – 1,000 | |
| Pit and fissure sealant | Deciduous tooth | 600 / tooth |
| Permanent tooth | 700 – 800 / tooth
Depend on position |
|
| Preventive resin restoration | ||
| 1,000 – 1,500 / tooth Depend on Size |
||
| Orthodontic treatment | Raise Bite | 5,000 / unit |
| Removable appliance | 6,000 / unit | |
| Standard Metal Fix appliance | 50,000 – 65,000
Depend on visits |
|
| Crystal Fix appliance | 75,000 | |
| Self Ligate Fix appliance / Damon | 80,000 | |
| Self Ligate Fix appliance / Damon Clear | 95,000 | |
| Invisalign appliance | 70,000 – 200,000
Depend on quantity of appliance |
|
| Orthodontic treatment in orthognathic surgery | 90,000 | |
| Removable Retainer | 2,500 – 3,000 / unit Depend on Type of Retainer |
|
| Fix Retainer | 6,000 / arch | |
| Mini-Implant | 5,000 / unit | |
| Band & Loop | 3,000 / unit | |
| Bracket (In case of bracket come off) | 500 – 1,000 / unit Depend on type of bracket |
|
| Whitening | In-office Bleaching | |
| Zoom Tooth Whitening | 10,000 / visit | |
| Home Bleaching | ||
| Bleaching tray | 2,000 | |
| Bleaching gel | 800 / cartridge | |
| Non-vital Tooth Bleaching | Non-vital Tooth Bleaching | 1,500 / visit |
| Night guard | 3,000 / unit | |
| Mouth guard | 6,000 / unit | |
| Occlusal splint | 6,000 / unit | |