What should a deep cleaning cost, and will insurance pay?
The short answer
Deep cleanings are priced per section of your mouth, usually four sections. The cost depends mostly on how many sections need it and how many teeth in each. Most plans pay a share of the cost for each section that meets the plan's criteria.
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 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.
- How many sections: each of the four sections is a separate charge.
- How many teeth in each: 4 or more teeth in a section (D4341) costs more than 1 to 3 teeth (D4342).
- Add-ons: an antibiotic placed in a pocket (D4381), usually charged per tooth, or extras like laser treatment or gum rinsing. See Watch for add-ons.
- Who does it: a periodontist (gum specialist) often charges more.
- Where you live: fees tend to run higher in areas with a higher cost of living.
The full bill is usually more than one line
- An exam, X-rays, and pocket measurements
- Sometimes heavy buildup removal first (D4355)
- The deep cleaning, one line per section
- Any antibiotic placed in pockets
- Afterward, ongoing gum maintenance cleanings (D4910). See Why are my cleanings now called “maintenance”?
A regular cleaning and a deep cleaning usually aren't both paid on the same day.
Watch for add-ons. A deep cleaning is sometimes paired with add-ons, such as laser treatment (often billed under a catch-all code, D4999) or rinsing the gums with a medicine (D4921). Many plans don't cover these, so you'd usually pay for them yourself. They aren't wrong to offer, but they're optional extras. Ask what each one adds for your case, and get the cost in writing before you agree.
Will insurance pay?
Most plans include coverage for deep cleanings, but whether yours pays depends on your records meeting its criteria (see below). Many plans count it as a basic service, but it varies from plan to plan, so check your plan's summary of benefits. The usual limits apply:
- Your deductible and coinsurance
- Your annual maximum
- Waiting periods, if your coverage is new
- Frequency limits: plans usually pay for a deep cleaning on the same section only once in a set number of years.
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, and the plan pays you back whatever benefits it covers.
What plans look for
Deep cleanings get a closer look from insurance plans than most treatments. Unlike crowns, where things like wear can affect coverage, the review for deep cleanings is fairly straightforward: plans look mainly at pocket depths and bone loss on X-rays, section by section. Their criteria are generally based on the same clinical evidence dentists use to diagnose gum disease. That makes a predetermination a useful second look before you start. A plan's decision is about payment, not a verdict on your care, but if a section doesn't meet the criteria, it's a good reason to ask your dentist about it.
Your dentist sends pocket measurements and X-rays with the claim.
If only some teeth in a section meet the criteria, the plan may pay as if a smaller deep cleaning was done. See Why did insurance only pay for a cheaper treatment? and how plans decide on deep cleanings.
If a section doesn't meet the criteria at all, whether an in-network dentist can bill you depends on your plan. For some plans, the decision is that the treatment doesn't fit that section, and the dentist can't bill you for it. See what you'll owe.
Ways to manage the cost
- Ask for a predetermination covering all the sections and any add-ons.
- Ask which sections are most urgent, and whether the rest can be spread over time or across plan years.
- Ask whether any add-on is needed for your case, and what it adds.
- Ask whether the office offers a payment plan.
- Dental school and hygiene school clinics often charge less, though visits take longer.
Questions to ask
- How many sections need it, and how many teeth in each?
- What's the total, including any add-ons and the follow-up visit?
- Are any of these add-ons optional, and does my plan cover them?
- Will you send pocket measurements and X-rays with the predetermination?
- How will my cleanings be billed afterward?
- Before we schedule, can I get my cost in writing? (A predetermination if I'm using insurance, or a good faith estimate if I'm paying myself.)
When a second opinion makes sense
Reasonable if all four sections are recommended but most of your pockets are shallow, or if the total includes add-ons you don't understand.