What does a second opinion cost, and will insurance pay?
The short answer
A second opinion is usually billed as an exam or a consultation, sometimes with new X-rays. Most plans include coverage for exams, but a second-opinion visit may count toward the same yearly limit as your checkups. Ask the new office how they'll bill it, and get the cost in writing before the visit.
What drives the price
We don't list prices here, because they vary too much to be useful. If your dentist is in network with your plan, the fee is set by your plan's contract with the dentist. If they're out of network, they set their own fee. The best way to know your cost is to ask the office for it in writing before your visit. If the cost is higher than you expected, it's reasonable to ask why, or to get a quote from another office.
- The kind of visit. It may be billed as an exam for one specific problem (D0140), a full exam if you're a new patient (D0150), or a consultation with a dentist other than your own (D9310).
- New X-rays. Bringing recent X-rays often means fewer new ones. The second dentist may still need a few of their own, or a 3D scan for some cases.
- Who you see. A specialist's visit often costs more than a general dentist's.
- In or out of network. Out-of-network offices set their own fees. See Can an in-network dentist charge me more?
How plans usually handle it
- Exams: most plans include coverage for exams, but they usually limit how many you get each year. A second-opinion exam may use one of those, so a later checkup could be denied as too soon. See frequency limits.
- Consultations (D9310): coverage varies from plan to plan. Some plans pay it like an exam; others don't cover it.
- X-rays: these have their own frequency limits. If you had a full set recently, a new set may not be covered, which is another reason to bring copies.
Your plan documents or member services can tell you exactly how yours works.
Ways to keep the cost down
- Bring your X-rays and treatment plan.
- Choose an in-network dentist if you're using insurance.
- Ask the office, when you book, how they'll bill the visit and what's included.
- Ask whether a dental school clinic near you offers second-opinion visits, often at a lower cost.
For a large treatment plan, the cost of one more visit is usually small next to the cost of the work itself.
Questions to ask
- (To the new office) How will you bill this visit: as an exam or a consultation?
- If I bring my X-rays, will you need to take new ones?
- Can I get the cost of this visit in writing?
- (To your plan) Does my plan cover a second-opinion visit, and does it count toward my yearly exam limit?