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Download Page

 
Download and print the entire Dental Benefits Fee Schedule by selecting your state from the list below.  Adobe Acrobat is required to view all fee schedules.

Fee Schedule by State

Alabama Hawaii

Michigan

North Carolina

Utah

Alaska Idaho

Minnesota

North Dakota

Vermont

Arizona

Illinois

Mississippi

Ohio

Virginia

Arkansas

Indiana

Missouri Oklahoma Washington
California

Iowa

Montana

Oregon

West Virginia

Colorado

Kansas

Nebraska

Pennsylvania

Wisconsin
Connecticut

Kentucky

Nevada

Rhode Island

Wyoming

Delaware

Louisiana

New Hampshire

South Carolina

 

D.C.

Maine

New Jersey

South Dakota  

Florida

Maryland

New Mexico Tennessee  
Georgia Massachusetts New York Texas  

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Disclosures
THIS PROGRAM IS NOT INSURANCE

This plan provides contracted discounts at certain providers for services and does not make payments to the providers. The plan member is obligated to pay for all services when services are rendered. Not available in all areas. Hospital discounts are not available in Maryland. Plan offered and administered by Benefit Services of America Inc., a Florida licensed Discount Medical Plan Organization, located at 101 Wymore Road, Suite 300, Altamonte Springs, FL 32714. This discount program contains a 30-day money back guarantee. +The dental network is provided by Signature Agency, Inc. ++30-Day Money Back Guarantee includes refund of activation fee. The range of discounts for medical and ancillary services provided under the plan will vary depending on the type of provider and medical or ancillary service received.