What should a night guard cost, and will insurance pay?
The short answer
The price depends mostly on the type of guard and who makes it. Many plans include coverage for night guards, but often with limits: how often they'll pay for a new one, and sometimes only when there are signs of grinding damage.
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 you're fitted. If the cost is higher than you expected, it's reasonable to ask why, or to get a quote from another office.
- Type: hard (D9944), soft (D9945), or partial (D9946).
- Who makes it: a dental lab, or a machine in the office.
- Where you live.
A store-bought guard costs far less. See Can I just buy one at the store or online?
What's usually included
The fee normally covers the impressions or scan, the guard, the fitting visit, and adjustments shortly after. Ask how long adjustments are included, and what a repair or replacement would cost if you lose or crack it.
Will insurance pay?
Plans vary a lot on night guards. Common rules:
- Covered, with a frequency limit, such as one guard every few years. See Insurance says I had this done too recently.
- Covered only for grinding, with your dentist's records showing signs of it. Guards meant to treat jaw joint problems (TMJ) are often handled differently. See Will it help my jaw pain or headaches?
- Not covered at all by some plans.
The usual limits apply too: your deductible and coinsurance, your annual maximum, and any waiting period. For more, see Why didn't insurance cover my night guard?
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.
Ways to manage the cost
- Ask for a predetermination so you know what your plan will pay.
- Bring your guard to checkups so it can be cleaned, checked, and adjusted. That helps it last.
- Store it in its case, away from pets and heat. Lost and chewed guards are a common reason for paying twice.
- Ask whether the office offers a payment plan.
- Dental school clinics often charge less, though visits take longer.
Questions to ask
- Which type of guard is this, and why that one?
- Which code will you bill: D9944, D9945, or D9946?
- Does the fee include adjustments? For how long?
- How often will my plan pay for a new one?
- What would a repair or replacement cost?
- 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
If the cost seems high, a quote from another office is reasonable. A night guard is a common, fairly simple appliance, so comparing is easy.