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Modern Dentistry usingState of the Art Equipment
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Modern Dentistry usingState of the Art Equipment
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![]()
Modern Dentistry usingState of the Art Equipment
Financial Information
Payment Methods Accepted
For your convenience, we accept cash, personal checks, MasterCard, Visa and Discover. If you choose one of these payment methods, fees for procedures completed in a single visit are due in full at that appointment. For procedures that require multiple visits, you may pay half the fee when treatment is started and the other half upon completion of treatment. Patients using dental insurance must remit their copayment or deductible when treatment begins.
Estimates
Third-Party Financing
Holly Dental Associates has teamed with CareCredit to eliminate financial barriers that stand in the way of quality dental care. As a leader in patient financing, CareCredit offers several payment plans, many with low or no interest for qualified applicants. Apply online at the CareCredit website.
Insurance
We accept numerous dental insurance plans and electronically file claims for our patients. If you have questions about your coverage, bring us a copy of your plan, and we’ll explain your benefits and coverage. Our front-office personnel work with insurance companies to expedite processing of claims and maximize patient benefits.
Please be aware that decisions regarding your treatment should not be based solely on your benefit coverage. To receive the quality care that you deserve for a strong, healthy smile, treatment should be determined by you and the dentist, not by your dental plan.
Insurance Plans
The following list shows the insurance programs with which we participate. To assure that we work with your specific plan, check with your employer and/or insurance company.
- Aetna Traditional Dental
- Aetna Dental PPO
- Ameritas PPO
- Careington (We do not accept the 500 Series Plans or Careington Care Discount Plan)
- CIGNA PPO Dental
- Connection Dental/GEHA
- DHA PPO/Sunlife
- Delta Dental PPO
- Delta Dental DPO
- Delta Dental Kaiser
- Delta Dental Traditional
- Delta Dental Premier
- Delta Dental EPO
- GEHA
- Guardian
- Humana Dental
- Metlife PDP
- Principal PPO
- Sunlife / DHA
- United Healthcare/DBP
Friends & Family Discount Plan
The Holly Dental Associates team is proud to offer an affordable option for patients without dental insurance. Our Friends & Family Discount Plan allows you to receive quality dental care at reduced rates. Members of the plan gain access to a reduced fee schedule, with many prices up to 30% off of our usual and customary fees.
- No annual limits
- Immediate activation of plan benefits
- No predetermination
- No waiting period
- No missing tooth clause
- No claim forms
- Yearly premiums
- No hidden fees
- No deductibles
You and your spouse are eligible, as well as your children under the age of 26 who reside with you or attend school. There’s no age limit for coverage of children diagnosed with a developmental disability or physical handicap.
All payments listed under the reduced fee schedule are made directly to our dental office when services are rendered.
Holly Dental Associates provides full-service dentistry to meet virtually all of your oral healthcare needs. However, in certain circumstances, the expertise of a specialist may be necessary. Your Friends & Family Discount Plan rates do not apply to services provided by specialists. Examples of specialists include endodontists, oral surgeons, periodontists, orthodontists, and pediatric dentists.
For an enrollment period of one year, an individual pay a non-refundable membership fee of $115.00; families pay $165.00. All family members interested in enrolling must do so at the same time and will receive the same effective date and enrollment period. Membership fees must be paid in full before any benefit can be used.
Enrollment in the Holly Dental Premium Pre-Pay Service Package includes a Friends and Family Discount Plan membership fee and yearly maintenance services with an additional 10% off the already reduce fee schedule. An individual adult member will pay $468.70. Adult Family member will pay $518.70. Each additional adult member will then pay $353.70 or $317.34 per child under 12 years of age that are enrolled.
| CODES | PROCEDURE | REG. FEE | FRIENDS & FAMILY DISCOUNT FEE | PREPAY 10% OFF |
| 120 | Periodic Oral Evaluation | $75.00 | $53.00 | $47.70 |
| 140 | Limited Oral Evaluation – Emerg.Office visit | $102.00 | $73.00 | $65.70 |
| 150 | Comp Oral Eval-New Or Estab Patient | $103.00 | $73.00 | $65.70 |
| 210 | Complete Series X-rays | $165.00 | $104.00 | $93.60 |
| 220 | Periapical X-ray | $32.00 | $24.00 | $21.60 |
| 230 | Periapical – Each Additional | $31.00 | $24.00 | $21.60 |
| 272 | 2 Bitewing X-rays | $40.00 | $42.00 | $37.80 |
| 273 | Bitewings – three films | $63.00 | $42.00 | $37.80 |
| 274 | 4 Bitewing X-rays | $73.00 | $53.00 | $47.70 |
| 330 | Panorex X-ray | $124.00 | $104.00 | $93.60 |
| 383 | CT SCAN BOTH ARCHS | $473.00 | $260.00 | $234.00 |
| 1110 | Prophylaxis – Adult | $122.00 | $93.00 | $83.70 |
| 1120 | Child Prophylaxis | $92.00 | $63.00 | $56.70 |
| 1208 | Fluoride Treatment-CHILD | $46.00 | $32.00 | $28.80 |
| 1351 | Sealant Per Tooth | $59.00 | $53.00 | $47.70 |
| 2330 | Composite – 1 Surface, Anterior | $204.00 | $127.50 | $114.75 |
| 2331 | Composite – 2 Surfaces, Anterior | $230.00 | $153.00 | $137.70 |
| 2332 | Composite – 3 Surfaces, Anterior | $278.00 | $178.50 | $160.65 |
| 2335 | Composite – 4+ Surface/Incisal Angle | $329.00 | $204.00 | $183.60 |
| 2391 | Resin Composite-1 Surface, Posterior | $209.00 | $127.50 | $114.75 |
| 2392 | Resin Composite-2 Surfaces, Posterior | $273.00 | $153.00 | $137.70 |
| 2393 | Resin Composite-3 Surfaces, Posterior | $306.00 | $178.50 | $160.65 |
| 2394 | Resin Composite-4+ Surfaces, Posterior | $337.00 | $204.00 | $183.60 |
| 2740 | Crown-All porcelain | $1,150.00 | $940.00 | $846.00 |
| 2750 | Crown-Porc/High Noble Metal | $1,150.00 | $940.00 | $846.00 |
| 2790 | Crown-Full Cast H/Noble Metal | $1,150.00 | $980.00 | $882.00 |
| 2950 | Core Build-up inc.pins | $307.00 | $204.00 | $183.60 |
| 2962 | Veneer-porcelain Laminate-laboratory | $1,224.00 | $940.00 | $846.00 |
| 3310 | Root Canal ANTERIOR | $898.00 | $612.00 | $550.80 |
| 3320 | Root Canal BICUSPID | $1,051.00 | $816.00 | $734.40 |
| 3962 | Zoom In-House Whitening | $291.00 | $240.00 | $240.00 |
| 4341 | Perio S/RP – 4+ Teeth per Quadrant | $278.00 | $165.00 | $148.50 |
| 4342 | Perio S/RP – 1-3 Teeth per Quadrant | $204.00 | $104.00 | $93.60 |
| 4355 | Full Mouth Debridement | $184.00 | $104.00 | $93.60 |
| 4910 | Perio Maintenance | $182.00 | $125.00 | $112.50 |
| 5110/5130 | Deluxe Full Denture &Transitional prosthetic | $3,500.00 | $2,500.00 | $2,295.00 |
| 5110/5130 | Deluxe replacement Denture | $2,000.00 | $1,500.00 | $1,350.00 |
| 5213 | Cast Partial – Metal Base | $2,040.00 | $1,530.00 | $1,147.50 |
| PER SITE | Bone Graft And Biologic Materials | $560.00 | $402.90 | $362.61 |
| Per/Tooth | Implant Body/Abutment/CrownPorc | $5,704.00 | $3,895.00 | $3,505.00 |
| 3 Unit | 3-Unit Bridge All Porc | $4,038.00 | $2,601.00 | $2,340.90 |
| 7140 | Ext. Erupted Tooth Or Exposed Root | $250.00 | $153.00 | $137.70 |
| 7210 | Surgical Extrac Erupted “Tooth | $347.00 | $229.50 | $206.55 |
| 7220 | Extraction – Soft Tissue Impac | $402.00 | $255.00 | $229.50 |
| 9940 | Occlusal Guard | $550.00 | $408.00 | $367.20 |
Premium Pre-Pay Service Package
This package lets you prepay for preventative maintenance visits and receive an addition 10% off of an already reduced fee schedule – great for patients who are planning their flex spending accounts.
Holly Dental Associates also provides discount plans for employers and groups. Call for details.
Your plan includes:
- Two simple cleanings
- Screening X-rays (four bitewings and two PAs)
- Two dental examinations
- A fluoride treatment, if needed
All maintenance services must be used during the enrolled period. Any unused services are forfeited and non-refundable. Patients who require periodontal maintenance cleanings or deep cleanings pay an extra charge. Additional fees also apply for full-mouth, Panorex, and other diagnostic X-rays. The reduced fee schedule does not apply to radiographs taken at a non-maintenance visit.
Enroll in the Holly Dental Associates Premium Pre-Pay Service Package and receive a Friends & Family Discount Plan membership at a reduced rate.
Holly Dental Associates
8010 S, Holly Street #100
Centennial, Colorado 80122
Office: 303-694-6400
Email:info@hollydental.com
