What should a crown cost, and will insurance pay?

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 treatment. If the cost is higher than you expected, it's reasonable to ask why, or to get a second opinion or a quote from another office.

• Material: all-ceramic, porcelain fused to metal, or all metal.
• Extra steps: a buildup (D2950), or a post and core after a root canal.
• Who makes it: a dental lab, or a same-day machine in the office.
• Who does it: a specialist (prosthodontist) for a complex case may charge more.
• Where you live.

• An exam and X-rays
• A buildup, if needed. See What's a buildup?
• The crown itself (the temporary is usually included)
• Sometimes other work first, such as a root canal or gum work to expose more tooth

Most plans include coverage for crowns, but whether yours pays depends on the tooth meeting its criteria (see below). Many count crowns as a major service, which often means a smaller share. Check your plan's summary of benefits. The usual limits apply:

• Your deductible and coinsurance
• Your annual maximum. One or two crowns can use up much of it, so ask how much you have left.
• Waiting periods, which are common for major services
• Replacement limits, if the tooth already had a crown
• Paying for a metal crown instead of a tooth-colored one on back teeth, in some plans

Watch for extra line items. If your dentist is in network, the lab work and the crown material, including a specific brand, are usually part of the crown fee your plan allows. A separate lab fee or material fee on top of that is typically not allowed under the plan's contract. If you see one, ask the office about it and check your Explanation of Benefits. (Paying the difference when your plan pays for a metal crown instead of a tooth-colored one is different, as explained above.) See Can an in-network dentist charge me more?

If your dentist is out of network, they can charge their own fee and bill you for whatever the plan doesn't pay. Out-of-network offices often collect the full fee up front. You can still send the claim to your plan, and it pays you back whatever benefits it covers.

Many plans check before paying for a crown. They look at your X-rays, and sometimes photos, for:

• How much tooth is lost from decay, a break, or a large old filling. A tooth with a smaller problem may qualify for a filling instead.
• The cause. Many plans don't pay for crowns on teeth damaged by wear, such as grinding. See how plans decide on crowns.
• Buildups: whether enough tooth was missing to need one. See What's a buildup?

Cracks are hard to see on an X-ray, so a photo or a note from your dentist describing the crack helps the plan see what your dentist saw. After a root canal, a crown nearly always meets criteria. See an example

A predetermination sends these same records to your plan before treatment, so you'll usually know whether the crown and any buildup meet its criteria before you commit.

• Ask for a predetermination covering the crown and any buildup together.
• If you need more than one crown, ask whether some can safely wait until your annual maximum resets.
• Ask about material options and how each is paid by your plan.
• Ask whether the office offers a payment plan.
• Dental school clinics often charge less, though visits take longer.