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Payment Policy

In order to offer the substantial savings available under the terms of this plan, we must adhere to the following payment policies:
The one year membership must be paid in full at the time of enrollment.
The membership will be valid for one year from the date the annual fee is remitted.
All treatment fees are due and payable at the time services are rendered.
All fees for treatment requiring multiple visits or lab fess are due upon the first visit.
The Smile Salon reserves the right to refuse treatment and/or terminate membership without notice if the member’s account becomes delinquent at any time. All other Smile Salon terms and conditions apply.

Exclusions
Procedure fee courtesy discounts offered under this plan shall not apply to any treatment already in progress prior to enrollment in the plan and may not be combined with dental insurance benefits, any other discounts, promotions or outside financing plans. This is not a dental insurance plan, but a discount plan; benefits are limited to treatment provided by The Smile Salon.

Savings Chart


ADA Office Fee OHSP Fee

D0140 Limited Oral Eval $82 $45

D0150 Comprehensive Eval $93 $50

D0120 Periodic Eval $53 $25

D0274 4 Bitewing x-rays $68 $35

D0220 Periapical film $30 $15

D0330 Panoramic film $120 $70

D1110 Adult Prophy $95 $55

D1120 Child Prophy $75 $40

D1206 Fluoride Application $30 $18

D7140 Simple Extraction $150 $70

D7210 Surgical Extraction $250 $135

D2391 Comp. Post 1 surface $190 $105

D2392 Comp. Post 2 surface $275 $145

D2393 Comp. Post 3 surface $310 $185

D2335 Comp. Post 4 surface $330 $200

D3330 Root Canal Molar $986 $705

D3320 Root Canal Bicuspid $850 $460

D3310 Root Canal Anterior $700 $370

D2740 Crown $1200 $735

D3120 Indirect Pulp Cap $40 $25

D2950 Build-Up $295 $155

D5110 Complete Denture $1500 $785

D5130 Immediate Denture $1700 $950

D5213 Metal Partial $1600 $850

D5211 Resin Partial $1100 $700





The Smile Salon and Day Spa
On the Country Club Plaza

801 W 47th St suite 110

Kansas City, MO 64112

816.931.2191

www.thesmilesalon.net


Gold Plan

Gold Membership $20/monthly

$40 set up fee

Gold Membership includes:

Oral Health Savings plan Discounted Rates in addition to:

20% savings on all restorative, cosmetic, endodontic, prosthetic, orthodontic, and surgical procedures performed in our office that are not listed in our discount price list.

Please see a Smile Salon team member for a complete listing of our Oral Health Savings Plan discounted rates and to get your plan started.



Platinum Plan

Platinum Membership $295/annual

Additional Family Member $150/annual

No set up fee

Platinum membership includes the following, plus Gold plan:

Two regular check-ups per year

$146 value D0150/D0120
Two regular cleanings per year

$190 value D1110


Preventative Radiographs

Four Bitewings (once per year)

Four single Periapical x-rays (once per year)

Panoramic (once per 5 years)

$308 value D0274/D0220/D0330

Fluoride Varnish (once per year)



$30 value D1206


At The Smile Salon, we recognize that quality dental care is beyond the reach of millions of Americans. To offset the spiraling cost of care, we have developed the

Oral Health Savings Plan Now, with the convenience of controlled cost and flexible hours, first class dental care is even more affordable than ever.




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