Dental (Aetna Dental Access)
| Service | Average Price1 | Member Price | Member Savings | % Savings |
|---|---|---|---|---|
| Routine 6 Month Check-Up | $42.00 | $23.00 | $19.00 | 46% |
| In Depth Check-Up | $72.00 | $33.00 | $39.00 | 54% |
| Full Mouth X-Rays | $125.00 | $59.00 | $66.00 | 53% |
| Four Bitewing X-Rays | $54.00 | $27.00 | $28.00 | 51% |
| Panoramic Film | $101.00 | $48.00 | $53.00 | 53% |
| Adult Teeth Cleaning | $77.00 | $44.00 | $33.00 | 43% |
| Child Teeth Cleaning | $53.00 | $31.00 | $23.00 | 42% |
| Protective Sealant / Tooth | $46.00 | $20.00 | $23.00 | 49% |
| 1 Surface White Filling for U or L Front Tooth | $112.00 | $55.00 | $57.00 | 51% |
| Single Crown - Porcelain on High Noble Metal | $918.00 | $565.00 | $354.00 | 39% |
| Single Crown - Porcelain on Noble Metal | $876.00 | $548.00 | $328.00 | 37% |
| Root Canal Treatment - Molar | $1,030.00 | $549.00 | $481.00 | 47% |
| Perio Scaling and Root Planing (Per Quadrant) | $219.00 | $120.00 | $99.00 | 45% |
| Full Upper Denture | $1,398.00 | $715.00 | $683.00 | 49% |
1Sample Average of National Dental Fees. Fees may vary slightly by region. (updated 6/2009)
Fee schedules may change without notice. Consult your plan dentist for current fees before beginning treatment.
Chiropratic Savings
| Service | Average Price1 | Member Price2 | Member Savings | % Savings |
|---|---|---|---|---|
| New Patient Problem Focused | $110.00 | $77.00 | $33.00 | 30% |
| New Patient Comprehensive | $180.00 | $126.00 | $54.00 | 30% |
| Established Patient Comprehensive | $85.00 | $59.50 | $26.00 | 30% |
| Chiropractic Manipulative Treatment 1-2 Regions | $45.00 | $31.50 | $13.50 | 30% |
| Chiropractic Manipulative Treatment 5+ Regions | $65.00 | $45.50 | $20.00 | 30% |
| Radiologic Exam, Full Spine Anteroposterior/Lateral | $185.00 | $92.50 | $92.50 | 50% |
| Muscle Testing-Cervical | $60.00 | $30.00 | $30.00 | 50% |
| Physical Performance Testing/Comprehensive Muscle Testing | $95.00 | $47.50 | $47.50 | 50% |
| Total | $825.00 | $509.50 | $315.50 | 38% |
1Average national price, prices vary by region.
2Average member price, prices vary by provider.
Diabetic Savings
| Service | Average Price | Member Price | Member Savings | % Savings |
|---|---|---|---|---|
| Glucose Meter | $70.61 | FREE | $70.61 | 100% |
| Test Strips 50ct | $48.72 | $29.99 | $18.73 | 38% |
| Lancing Device | $12.32 | $7.99 | $4.33 | 35% |
Prices may vary by location.
Hearing Savings
| Service | Average Price | Member Price | Member Savings | % Savings |
|---|---|---|---|---|
| Basic (100% digital, 2channels, 2 memories) | $1,595.00 | $995.00 | $600.00 | 37% |
| Medallion (100% digital, 7 channels, 3 memories, voice processing, feedback detection) | $3,595.00 | $1,495.00 | $2,100.00 | 58% |
| Ultra (100% digital, 14 channels, 3 memories, feedback detection, 6 compression areas, noise reduction, speech preservation etc.) | $4,755.00 | $1,995.00 | $2,760.00 | 58% |
All preferred prices are considered "payment in full" when included services are rendered by a participating provider.
Prescription & Pharmacy Savings
| Common Name | Actual Brand Name | Strength/Qty | Average Price | Member Price | Member Savings | % Savings |
|---|---|---|---|---|---|---|
| Vicodin | Hydrocodone-APAP | 5-500mg/40qty | $17.52 | $11.01 | $6.51 | 37% |
| HCTZ | Hydrochlorothiazide (HCTZ) | 25mg/30qty | $8.51 | $6.53 | $1.98 | 23% |
| Amoxicillin | Amoxicillin | 500mg/21qty | $14.00 | $10.24 | $3.76 | 27% |
| Glucophage | Metformin HCL | 500mg/60qty | $23.76 | $13.32 | $10.44 | 44% |
| Zithromax | Azithromycn | 250mg/6qty | $48.45 | $30.36 | $18.09 | 37% |
| Xanax | Alprazolam | 0.5mg/60qty | $19.78 | $11.49 | $8.29 | 42% |
| Bactrim DS | Sulfamethozazole-Trimethprim (SMZ-TMP) | 80-160mg/20qty | $14.08 | $11.72 | $2.36 | 17% |
| Darvocet | Propoxyphene Napsylate-APAP | 100-650mg/45qty | $23.31 | $14.15 | $9.16 | 39% |
| Soma | Carisoprodol | 350mg/60qty | $37.80 | $17.96 | $19.84 | 52% |
| Zestril | Lisinopril | 20mg/30qty | $17.18 | $11.49 | $5.69 | 33% |
Vision Savings
| Item | Average Price1 | Member Price1 | Member Savings | % Savings |
|---|---|---|---|---|
| Frames | ||||
| Via Spiga Treviso 710 | $209.95 | $79.95 | $130.00 | 62% |
| Timberland Pro Frame P702 | $99.99 | $49.98 | $50.01 | 50% |
| Guess GU 1148 | $129.96 | $84.47 | $45.48 | 35% |
| Candie | $99.95 | $45.00 | $54.95 | 55% |
| Brooks Brother | $139.00 | $90.35 | $48.65 | 35% |
| Optique | $280.00 | $182.00 | $98.00 | 35% |
| Lenses | ||||
| Single Vision | $59.00 | $24.95 | $34.05 | 58% |
| Bifocal | $130.00 | $50.00 | $80.00 | 62% |
| Progressive | $219.00 | $134.23 | $84.77 | 39% |
| Contact Lenses | ||||
| B & L Softlens 38 - (6 pack) | $21.99 | $15.50 | $6.49 | 30% |
| Durasoft 3 Custom (Per Lens) | $99.00 | $49.50 | $49.50 | 50% |
| Lasik Surgery | ||||
| Lasik Surgery TLC Eye Center | $5,500.00 | $3,850.00 | $1,650.00 | 30% |
| Mail Order Replacement Contact Lens Program | ||||
| Acuvue (6 pack) | $23.95 | $14.95 | $9.00 | 38% |
| A V Bifocal (6 pack) | $52.95 | $30.95 | $22.00 | 42% |
| Edge 3 (Per Lens) | $22.95 | $14.50 | $8.45 | 37% |
| Focus Toric (6 pack) | $79.95 | $44.50 | $35.45 | 44% |
| Fresh Look Blends (6 pack) | $44.95 | $32.50 | $12.45 | 28% |
1Price may vary slightly by region.
Fee schedules may change without notice. Consult your provider for current fees before beginning treatment.
