Your Fees, Payments, and Insurance Questions — Answered
At Crystal Smiles, we believe in transparent, straightforward pricing. Our fees are based on the most current Alberta Dental Association Fee Guide, and our team is always happy to walk you through costs before any treatment begins. Below you’ll find answers to our most common billing and payment questions.
We follow the most up-to-date ADA Dental Fee Guide. For your convenience and reference, we’ve provided a list of some of our most common fees below.
Yes, we can provide pre-procedure estimates for any dental treatments, as outlined by your insurance provider.
We will bill your insurance provider directly on your behalf. Any estimated amount not covered by your insurance will be collected at the time of service. Our team is here to help with any questions you may have.
We accept Visa, MasterCard, American Express, debit, and cash. We’re happy to work with you to find payment arrangements that best fit your budget.
We’re pleased to offer customized payment plans to help make dental treatment accessible and affordable for all patients.
Coverage depends on your specific policy, but if you have orthodontic benefits, a portion of Invisalign treatment may be covered. Please note that direct billing is not available for Invisalign; however, we can submit monthly claims on your behalf upon request.
For a full breakdown of our fees by service, see the complete 2026 fee guide below.
Prevention Services
These services prevent oral diseases or their progression.
Polishing
A service that removes stain and plaque. One unit of time is 15 minutes.
| Code | Fee | Description |
|---|---|---|
| 11101 | $77.75 | One unit of time (15 minutes) |
| 11107 | $38.85 | Half unit of time (7.5 minutes) |
Scaling
Removal of calculus/tartar and hardened debris from the tooth’s surface above and below the gum line. One unit of time is 15 minutes.
| Code | Fee | Description |
|---|---|---|
| 11111 | $87.25 | One unit of time (15 minutes) |
| 11112 | $174.50 | Two units of time (30 minutes) |
| 11113 | $261.75 | Three units of time (45 minutes) |
| 11117 | $43.60 | Half unit of time (7.5 minutes) |
Fluoride Treatment
A preventive service to reduce the risk of getting cavities.
| Code | Fee | Description |
|---|---|---|
| 12112 | $37.65 | Topical fluoride – application of a gel, foam, or varnish fluoride treatment to reduce the risk of getting cavities |
Sealants
Coatings applied to the chewing surfaces of back teeth to reduce the risk of cavity development by making those surfaces smoother and less retentive of food debris.
| Code | Fee | Description |
|---|---|---|
| 13401 | $42.40 | Single tooth – coating to reduce the risk of cavity development |
Diagnostic Services
Services that aid in the detection and diagnosis of diseases or conditions of the mouth, head, and neck, including check-ups.
Exams
| Code | Fee | Description |
|---|---|---|
| 01101 | $89.80 | Primary dentition – complete dental examination of a child with baby teeth only |
| 01102 | $122.35 | Mixed dentition – complete dental examination of a child with a mix of baby and adult teeth |
| 01103 | $143.85 | Permanent dentition – complete dental examination of an adult with only adult teeth |
| 01202 | $81.05 | Recall oral examination – dental examination of an adult or child previously seen by the same dentist |
| 01204 | $81.05 | Specific examination – dental examination of an issue in a localized area only |
| 01205 | $81.05 | Emergency examination – dental examination and investigation of pain or infection in a localized area only |
Periodontal
Relates to the gums, bone, and other supporting structures of the teeth and mouth.
| Code | Fee | Description |
|---|---|---|
| 01501 | $259.95 | Periodontal examination – includes recording of gum pocket depth |
Periapical X-Rays
A type of x-ray that shows the entire tooth crown, root, and surrounding bone. Can detect cysts, bone tumors, and abscesses.
| Code | Fee | Description |
|---|---|---|
| 02111 | $37.60 | Single periapical x-ray image |
| 02112 | $59.90 | Two periapical x-ray images |
Bitewing X-Rays
A type of x-ray that shows the crowns of several upper and lower teeth simultaneously. Helps detect cavities between teeth, evaluate bone health, and detect tartar deposits.
| Code | Fee | Description |
|---|---|---|
| 02142 | $59.90 | Two bitewing x-ray images |
| 02144 | $110.10 | Four bitewing x-ray images |
Panoramic X-Ray
A type of x-ray that shows many structures at once including the teeth, surrounding bone, the temporomandibular joint (TMJ), and other facial structures.
| Code | Fee | Description |
|---|---|---|
| 02601 | $111.40 | Single panoramic x-ray image |
Restoration Services
Procedures that replace lost tooth structure such as fillings or crowns.
Primary Teeth, Amalgam Restorations
Metal silver-coloured filling for baby teeth.
| Code | Fee | Description |
|---|---|---|
| 21112 | $176.30 | Two surfaces – metal silver-coloured filling covering 2 of the 5 tooth surfaces |
Amalgam, Bonded, Permanent Molars
Metal silver-coloured filling for adult teeth, bonded chemically and micro-mechanically to the tooth.
| Code | Fee | Description |
|---|---|---|
| 21242 | $249.50 | Two surfaces – metal silver-coloured bonded filling covering 2 of the 5 tooth surfaces |
Prefabricated Metal Primary Crown
A crown or cap for baby teeth, frequently referred to as a stainless-steel crown; covers the entire baby tooth.
| Code | Fee | Description |
|---|---|---|
| 22211 | $258.70 | Primary posterior – metal crown for a baby back tooth |
Permanent Anteriors, Bonded Technique
Tooth-coloured filling for adult front teeth, bonded chemically and micro-mechanically to the tooth.
| Code | Fee | Description |
|---|---|---|
| 23111 | $173.95 | One surface – tooth-coloured filling covering 1 of the 5 tooth surfaces |
| 23112 | $208.25 | Two surfaces – tooth-coloured filling covering 2 of the 5 tooth surfaces |
| 23113 | $272.40 | Three surfaces – tooth-coloured filling covering 3 of the 5 tooth surfaces |
Permanent Bicuspids, Bonded Technique
Tooth-coloured fillings for adult bicuspid (premolar) teeth, bonded chemically and micro-mechanically to the tooth.
| Code | Fee | Description |
|---|---|---|
| 23311 | $182.40 | One surface – tooth-coloured filling covering 1 of the 5 tooth surfaces |
| 23312 | $254.05 | Two surfaces – tooth-coloured filling covering 2 of the 5 tooth surfaces |
| 23313 | $297.55 | Three surfaces – tooth-coloured filling covering 3 of the 5 tooth surfaces |
Permanent Molars, Bonded Technique
Tooth-coloured fillings for adult molar teeth, bonded chemically and micro-mechanically to the tooth.
| Code | Fee | Description |
|---|---|---|
| 23321 | $210.80 | One surface – tooth-coloured filling on adult molars covering 1 of the 5 tooth surfaces |
| 23322 | $268.75 | Two surfaces – tooth-coloured filling on adult molars covering 2 of the 5 tooth surfaces |
| 23323 | $336.55 | Three surfaces – tooth-coloured filling on adult molars covering 3 of the 5 tooth surfaces |
Tooth-Coloured, Primary Posteriors, Bonded Technique
Tooth-coloured filling on a baby back molar tooth, bonded chemically and micro-mechanically to the tooth.
| Code | Fee | Description |
|---|---|---|
| 23512 | $232.15 | Two surfaces – tooth-coloured filling on a baby molar covering 2 of the 5 tooth surfaces |
Crown, Porcelain/Ceramic/Polymer Glass – Uncomplicated
A crown (cap) covering a tooth with porcelain or porcelain fused to metal. [L] denotes laboratory charges in addition to the dentist’s fee, which vary case to case.
| Code | Fee | Description |
|---|---|---|
| 27211 | $1,072.55 | Fused to metal base [L] – porcelain fused to metal crown |
Endodontics
Root canal therapy – treatment of a tooth having a damaged pulp/nerve.
Pulpotomy, Primary Teeth
Removal of the top portion of the pulp/nerve of a baby tooth so that the pulp/nerve in the root remains intact and viable.
| Code | Fee | Description |
|---|---|---|
| 32232 | $98.50 | Concurrent with restoration – removal of the coronal portion of the pulp/nerve of a baby tooth (does not include the final restoration) |
Root Canals, Permanent – Uncomplicated
Includes completely removing the pulp/nerve, sterilizing the canal spaces, and filling with biocompatible sealing material.
| Code | Fee | Description |
|---|---|---|
| 33111 | $795.45 | One canal – root canal of a tooth with 1 nerve canal |
| 33121 | $1,158.35 | Two canals – root canal of a tooth with 2 nerve canals |
| 33131 | $1,354.65 | Three canals – root canal of a tooth with 3 nerve canals |
Periodontics – Oral Disease
Diagnosis, prevention, and treatment of diseases and conditions of the supporting and surrounding tissues of the teeth.
Root Planing
Scraping of a bacteria-impregnated outer layer of cementum from the tooth root surface to prevent or treat gum disease (periodontitis). One unit of time is 15 minutes.
| Code | Fee | Description |
|---|---|---|
| 43421 | $94.45 | One unit of time (15 minutes) |
| 43422 | $188.85 | Two units of time (30 minutes) |
| 43423 | $283.30 | Three units of time (45 minutes) |
| 43427 | $47.20 | Half unit of time (7.5 minutes) |
Prosthodontics – Removable
Dentures, partial or complete, that can be removed by the patient. [L] denotes laboratory charges in addition to the dentist’s fee, which vary case to case.
Standard Dentures
Uncomplicated complete or partial lower removable dentures.
| Code | Fee | Description |
|---|---|---|
| 51101 | $1,052.45 | Maxillary [L] – complete upper removable denture |
| 51102 | $1,052.45 | Mandibular [L] – complete lower removable denture |
| 53102 | $1,192.80 | Mandibular [L] – partial lower removable cast metal frame, free end (no back teeth to support the denture) |
Adjustments, Partial or Complete Denture, Minor
Adjustment for any reason to a partial or complete denture. One unit of time is 15 minutes.
| Code | Fee | Description |
|---|---|---|
| 54201 | $90.70 | One unit of time [L] |
Repair, Complete Denture, Impression Required
| Code | Fee | Description |
|---|---|---|
| 55201 | $183.30 | Maxillary [L] – upper denture repair, impression required |
Reline, Processed, Complete Denture
Resurfacing the tissue side of a denture with new material to improve the fit.
| Code | Fee | Description |
|---|---|---|
| 56231 | $296.75 | Maxillary [L] – upper complete processed denture reline |
Prosthodontics – Fixed
Bridges that cannot be removed by the patient, replacing one or more missing teeth. Attached to natural teeth and/or implants. [L] denotes laboratory charges in addition to the dentist’s fee, which vary case to case.
Pontics, Porcelain/Ceramic/Polymer Glass
The artificial tooth portion of a bridge that replaces a missing tooth.
| Code | Fee | Description |
|---|---|---|
| 62501 | $570.30 | Fused to metal [L] – artificial tooth connected to other pontics or bridge retainers |
Retainers, Porcelain/Ceramic/Polymer Glass, Fused to Metal Base
Cap or crown on the tooth or teeth that retains a bridge in the mouth. Replacing one missing tooth typically requires two retainers plus one pontic.
| Code | Fee | Description |
|---|---|---|
| 67211 | $1,172.65 | Fused to metal base [L] – bridge retainer that pontics attach to |
Oral and Maxillofacial Surgery
The removal of teeth.
Removals, Erupted Teeth – Uncomplicated
The extraction (pulling) of an erupted tooth.
| Code | Fee | Description |
|---|---|---|
| 71101 | $174.55 | Single tooth, uncomplicated – extraction of 1 erupted tooth |
Removal, Erupted Teeth – Complicated
Extraction of an erupted tooth requiring a surgical approach, such as cutting soft tissue and/or bone.
| Code | Fee | Description |
|---|---|---|
| 71201 | $314.75 | Odontectomy – erupted tooth extraction requiring surgical flap (cutting of the gums) and/or sectioning of tooth |
Orthodontics
The supervision, guidance, and correction of the growing or mature dental and facial structures.
Observations and Adjustments
| Code | Fee | Description |
|---|---|---|
| 80601 | $100.40 | For tooth guidance – observation of tooth position, eruption sequence, serial extraction supervision; per appointment |
Appliances, Removable, Cross-Bite Correction
A condition in which the upper teeth bite inside the lower teeth. [L] denotes laboratory charges in addition to the dentist’s fee, which vary case to case.
| Code | Fee | Description |
|---|---|---|
| 81121 | $412.40 | Maxillary, simple [L] – upper appliance to correct a cross-bite |
Adjunctive General Services
Conscious Sedation
A medically controlled state of depressed consciousness that allows protective reflexes to be maintained. Used to help anxious patients of all ages relax during treatment. The patient remains awake throughout.
| Code | Fee | Description |
|---|---|---|
| 92412 | $106.60 | Two units of time – measured from placement to removal of the nitrous delivery device |
Fees listed are based on the 2026 Alberta Dental Association Suggested Fee Guide for General Dentists (effective January 1 – December 31, 2026). Each dentist sets their own fees, and the procedures listed may not cover your specific treatment needs or the actual cost of your care. [L] indicates additional laboratory charges that vary case to case. Please contact our office for a personalized treatment estimate.
Taking Care of Your Oral Health
A healthy smile starts with a visit to the dentist. We’ll thoroughly examine your teeth, gums, and mouth to monitor for signs of decay or infection. If a tooth extraction is necessary, you can rely on our compassionate care.
Don’t hesitate when it comes to taking care of your family’s oral health. Book your next appointment today.
Schedule AppointmentVisit Our Okotoks Dental Clinic
Our Address
- #108, 26 Crystal Ridge Dr.
- Okotoks, AB T1S 2C3
Contact Information
- Phone: (587) 757-9809
- Email: admin@crystalsmiles.ca
Our Hours
- Monday: 11:00 AM – 7:00 PM
- Tuesday: 11:00 AM – 7:00 PM
- Wednesday: 8:00 AM – 4:00 PM
- Thursday: 8:00 AM – 4:00 PM
- Friday: 8:00 AM – 3:00 PM
- Saturday: Closed
- Sunday: Closed
Free Invisalign Consultations: Supporting Healthy, Beautiful Smiles
We want you to love your smile! Invisalign can straighten your teeth, bringing your smile into alignment in a way that promotes both the symmetry and health of your teeth.
If your bite is misaligned, it can be tricky—or even impossible—to completely clean between your teeth. And if your teeth aren’t in the right position, they can actually damage each other over the years. That means even if your teeth are alright today, they may be at risk down the road.
Curious what your smile could look like after Invisalign? Book a free, personalized Invisalign consultation with Dr. Lindsay Raoufi today.
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Crystal Smiles Dental
- #108, 26 Crystal Ridge Dr.
- Okotoks, AB T1S 2C3
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P: (587) 757-9809
admin@crystalsmiles.ca