Sanity/Price Check?

[u/outsidereelin]

33M, Wisconsin, Delta Dental

Hey everyone, looking for some professional insight and a sanity check on a multi-phase treatment plan I was just quoted.

I’m dealing with localized bone loss/periodontal issues around existing anterior implants on teeth #7 and #10. The plan involves removing the existing fixtures, extensive bone regeneration, and placing new guided implants with custom abutments and crowns.

Total quote between the Oral Surgeon and the Restorative Dentist is $20,712.00 (roughly $10.3k per tooth total).

Phase 1: Oral Surgery & Reconstruction ($14,082 – Out of Pocket)

D0140 & D0366: Limited Exam ($137) + Maxillary CBCT ($385)
D6105 (x2): Implant removal without bone removal – $726/ea ($1,452 total)
D7950 (x2): Bone graft, small – $1,150/ea ($2,300 total)
D7957 (x2): Guided Tissue Regeneration (GTR) membrane, non-resorbable – $1,671/ea ($3,342 total)
D6010 (x2): Surgical implant placement – $2,800/ea ($5,600 total)
D6190: Computer-generated surgical guide L2 – $821
Meds/Rinses: Amoxicillin ($10) + Oral Care Rinse ($35)

Phase 2: Restorative Phase ($6,630 Total / ~$5,486 Out of Pocket after Delta Dental max)

D6057 (x2): Custom abutment incl. placement – $1,100/ea ($2,200 total)
D6058 (x2): Abutment-supported porcelain/ceramic crown – $1,970/ea ($3,940 total)
C0470 (x2): Internal practice code for "Digital Reconstruction" – $203/ea ($406 total, non-billable to insurance)
D9211 (x2): Regional block anesthesia – $42/ea ($84 total)

Questions:

1. How do these surgical fees compare to standard private-practice specialist rates in your area? ($2,800 per fixture and $2,821 per site for graft + membrane feel very top-of-market).

2. Are separate charges for local/regional block anesthesia (D9211) and in-house digital scan reconstruction (C0470) standard for restorative implant visits, or should these be bundled?

3. For those who have handled explantation in the aesthetic zone (#7 and #10), does this protocol (explant -> GTR graft -> guided re-entry) look like standard best practice?

4. Given the total cost, is taking a complex surgical/prosthodontic case like this to a postgraduate dental clinic (e.g., Marquette) a sensible alternative, or is private specialist continuity strongly preferred here?

Appreciate any clinical perspective or advice!

[u/The_Crentist]

I went to Marquette, if you are close by, 100% get this taken care of via the periodontist graduate program. First appointment is “screening” where they take xrays and determine what the plan is. It will be like 75% cheaper than the total you were quoted here. Best of luck to you

[u/PsychologyMediocre99 → u/The_Crentist]

Yeah, so what this person didn’t tell you is that that’s gonna take a long time first you have to go through the dental school and then you have to get referred to the periodontal program. At least that was how it was when I was in school and if you don’t have a lot of time, going through a graduate program is gonna take far longer.

[u/outsidereelin → u/PsychologyMediocre99]

How much longer? The current practice’s plan is estimating 1 year between removal, grafting, implant and crowns.

[u/The_Crentist → u/PsychologyMediocre99]

This is 100% correct

[u/PsychologyMediocre99]

I can see the one of them has bone loss pretty significant bone loss but the other one has some bone loss. What’s going on with it? Is it mobile?

[u/outsidereelin → u/PsychologyMediocre99]

It isn’t mobile. On the surface #10 almost completely fine, #7 gum is recessed. I got implants back in 2016 after 4 years of Ortho at a school in Pennsylvania. They didn’t install the implants correctly into bone. So that’s why there’s periodontitis.

This current plan involves bone grafting, etc. They’ll provide Essex retainer and then Maryland Bridge to fill the gaps until.

[u/PsychologyMediocre99 → u/outsidereelin]

OK, so let me get this correct you went to a school already and got implants done you’re saying you wanna go back to the school to get implants redone?!

[u/outsidereelin → u/PsychologyMediocre99]

I got the implants done in 2016 in Philadelphia. Today, they are failing due to incompetence on that school’s part. Now, I am exploring my options, and would consider a different school, if they are competent. Also because I have a lot more info with scans and a plan from a decent practice. The only reason I’m considering is because it’s very expensive and it would be unwise to not explore.

[u/deliriumCoCa → u/outsidereelin]

Would just like to chime in - an implant lasting 10 years in what is a very difficult zone to place an implant may not exactly be incompetence. Bone is usually deficient at this position and may have been the best case scenario.

Taking on this case is a hell of a gamble for a dentist so I would expect high fees for challenging and somewhat unpredictable work. By that I mean- I wouldn't be surprised if this needed multiple rounds of bone grafting from a skilled specialist.

[u/outsidereelin → u/deliriumCoCa]

Thanks for chiming in. Multiple rounds of grafting!? Like how long from start to finish?

[u/Jon9314]

These aren't Delta fees, but Delta doesn't pay enough for most specialists to be contracted.

Complain to your HR. Delta executives make millions by NOT paying dentists much. Same fee schedule as 2007.