What should an implant 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.

• How many parts: implant, abutment, and crown, plus any extraction, graft, or scan. See Why are there so many lines on my plan?
• Grafting: a graft or sinus lift adds cost and time.
• Materials and design: a stock or custom abutment, the crown material, or a one-piece crown that attaches directly to the implant with no separate abutment.
• Who does it: a specialist often charges more, and two offices may each bill their part.
• Where you live.

Implant coverage varies more than most treatments:

• Covered, often as a major service, with the usual limits.
• Paid as a cheaper option. Some plans pay what they'd pay for a partial denture or a bridge, and you pay the difference. See alternate benefits.
• Not covered. Some plans exclude implants. See Why doesn't my plan cover this at all?
• Parts covered differently. A plan may pay for the crown but not the implant, or not cover grafts or 3D scans.

One crown, two ways. Most implant crowns are billed as two lines, the abutment and the crown. A one-piece crown that attaches directly to the implant is usually billed as a single line that includes both. Neither is a sign of a problem; ask your office which kind you're getting so the estimate matches.

Other limits that often come up with implants:

• The missing tooth clause: some plans won't pay to replace a tooth lost before your coverage started.
• A tooth you were born without: some plans don't pay to correct a condition present from birth, which can include replacing a tooth that never formed with an implant. This is a separate rule from the missing tooth clause, and it's usually spotted when the plan's dentist reviews your X-rays. It comes up often for teens and young adults missing a front tooth.
• Waiting periods for major services.
• Your annual maximum. An implant can use up all of it. Because implants are done in stages over months, the steps sometimes fall in different plan years, which can help. Ask your dentist whether the timing can work that way.
• Replacement limits if the spot already had a bridge or partial denture paid for recently.

Medical insurance usually doesn't pay for implants, but it may help in some cases, such as teeth lost in an accident or jaw reconstruction after cancer treatment. If that applies to you, ask your medical plan.

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.

Plans may review your X-rays and records for things like when the tooth was lost (for the missing tooth clause), the health of the bone and nearby teeth, and whether a tooth being replaced was one you were born without (see a tooth that never grew in). See My treatment didn't meet the plan's criteria.

A predetermination covering every part (extraction, graft, implant, abutment, and crown) is especially worth it for implants, because there are so many pieces and so much money involved.

• Ask for one written estimate covering every step, from every office involved.
• Ask whether the steps can be timed across two plan years.
• Compare the cost of an implant, a bridge, and a partial denture after insurance. See your options.
• Ask whether the office offers a payment plan.
• If you have a health savings account (HSA) or flexible spending account (FSA), IRS rules generally count dental treatment and artificial teeth (which can include implants) as eligible expenses, but not purely cosmetic work. Check with your account's administrator.
• Dental school clinics often charge less, though treatment takes longer.