We accept all PPO dental insurance and submit claims for you. We're transparent about how it works — and why we made the choice to be out-of-network.
We are not in-network with any dental insurance plans, we do not accept medical insurance, and we do not offer in-house payment plans. We've made this choice deliberately so we can dedicate the time each case truly needs — typically 60–90 minutes of microscope-guided care — rather than the 30–40 minutes most insurance contracts allow.
The good news: <strong>most PPO patients still see 40–80% of the cost covered by insurance</strong>. With Delta Dental, the check is mailed directly to you. With most other PPOs (MetLife, Cigna, Aetna, Guardian, Anthem, United Healthcare, and similar), the insurer pays our office and we refund you that portion. Either way, we submit the claim as a courtesy and give you a written cost estimate before treatment begins so there are never any surprises.
A note on timing: national claims data shows average endodontic fees rose about 3–7% per year in 2024 and 2025, and treatment volume surges every January when annual benefits renew (Fluent Research / American Association of Endodontists, Q1 2026 market analysis). If you have a tooth that needs treatment and unused benefits, acting before year-end usually costs less and books faster than waiting for the new-year rush.
Including Delta Dental, MetLife, Cigna, Aetna, Guardian, Anthem Blue Cross, United Healthcare, Principal, Ameritas, and more. We submit claims as a courtesy.
Out-of-network — Delta Dental mails the check to you; most other PPOs pay our office and we refund you the insurance portion.
6, 12, and 18-month no-interest payment plans through CareCredit (third-party). We do not offer in-house payment plans. Apply online at carecredit.com or in our office. carecredit.com
Visa, Mastercard, American Express, Discover. Debit cards accepted. Contactless payment available.
Health Savings Account and Flexible Spending Account cards accepted for all eligible procedures.
What we do not accept: DMO/HMO plans (because they require in-network status), Medicaid/Medi-Cal, Denti-Cal, and medical insurance. If you have one of these, we'll discuss self-pay options, courtesy discounts, and CareCredit financing.
We've written a plain-English guide for each major PPO carrier explaining exactly how your benefits apply at an out-of-network specialist — what's covered, what you'll pay, and how we file your claim.
Every case is different. Rather than publish a generic price list that may or may not apply to your situation, we give every patient a written estimate tailored to the specific tooth, the complexity of the case, and your insurance benefits.
Send us a photo of your card before the visit, or bring it in. We verify your out-of-network benefits directly with your carrier — no guesswork.
A consultation, X-rays, and (if needed) a CBCT scan tell us exactly what the treatment will involve — anatomy, prior work, infection patterns, and risk factors.
In writing, before any treatment begins: total fee, expected insurance reimbursement, and your estimated out-of-pocket. You decide from there. No pressure, no surprises.
A molar root canal in a tooth with three straight canals and no prior treatment is a very different procedure from a retreatment with a separated instrument and calcified anatomy. Listing one number for both would be misleading — and it would set the wrong expectation for the patients who need our most careful work.
Call us at (669) 234-2354 or send your tooth number and a current X-ray to siliconvalleyendo@gmail.com, and we'll give you a realistic estimate over the phone — no appointment required.
Take five minutes to call the member services number on the back of your insurance card. The answers below will tell you almost everything you need to know about your out-of-pocket cost — and can save you from any surprise.
Most PPO plans cover endodontic treatment at 50–80% of the carrier's allowed amount once your deductible is met. Ask for the specific percentage and whether it's based on UCR (usual, customary, and reasonable) or a fixed fee schedule.
Most dental plans cap reimbursement at $1,000–$2,500 per calendar year. Knowing what's left tells you whether splitting treatment across two benefit years would save you money.
Some plans require pre-authorization for retreatments and apicoectomies. Most approvals come back in 7–14 days. We file these for you at no charge — just give us a few days notice.
Don't want to call? Email a photo of the front and back of your insurance card to siliconvalleyendo@gmail.com and we'll do this for you. We'll have your verified benefits ready by your appointment.
We verify your insurance benefits and provide a written cost estimate, including your expected out-of-pocket after reimbursement. You'll know what to expect before any work begins.
Payment in full is collected at the time of service via credit card, HSA/FSA, CareCredit, or check.
We submit a complete insurance claim to your PPO carrier as a courtesy — including narrative, X-rays, and CBCT if needed — to maximize your reimbursement.
With Delta Dental, the check is mailed directly to you, typically within 2–6 weeks. With most other PPOs (MetLife, Cigna, Aetna, Guardian, Anthem, United Healthcare, and similar), the insurer pays our office and we promptly refund you the insurance portion of what you already paid at your visit. Either way, out-of-network coverage is usually 40–80% of treatment cost depending on your plan.
If your insurer denies or underpays a claim, we help you appeal. We've handled hundreds of appeals successfully.
A growing number of states have passed dental-insurance reforms that make it easier to see the specialist you choose. Protections vary by state and plan, so always confirm the specifics with your own insurer — but here's what to look for.
Many states now require insurers to honor "assignment of benefits" — meaning your plan can send its share straight to our office instead of mailing you a check. Where that applies, you only pay your portion, not the full fee upfront.
Newer "medical loss ratio" rules require dental insurers to spend most of your premium (commonly 80–85%) on actual care rather than overhead — and to issue rebates when they fall short. It's a useful transparency check when comparing plans.
For urgent tooth pain, PPO rules generally do not require prior authorization before emergency endodontic care. You can be seen right away for pain relief; the claim is processed afterward based on dental necessity.
Not sure which of these apply to your plan? Email a photo of the front and back of your insurance card to siliconvalleyendo@gmail.com and we'll check your benefits and how reimbursement will work before you're seen.
Yes, payment in full is collected on the day of treatment. Your reimbursement comes back to you within 2–6 weeks — Delta Dental mails the check directly to you, while most other PPOs pay our office and we refund you the insurance portion. If paying in full is a hardship, CareCredit offers no-interest financing for 6, 12, or 18 months for qualifying patients.
Out-of-network plans typically reimburse 40–80% of the treatment cost. The exact percentage depends on your specific plan's out-of-network benefit. We verify your benefits before treatment so you know what to expect.
DMO and HMO plans require providers to be in-network at heavily reduced fees that don't allow the time or care our patients need. Medi-Cal and Denti-Cal don't typically cover the specialty endodontic procedures we perform. We can recommend in-network providers for these plans if needed. Even though we can't bill these plans, we can often provide a courtesy discount if you pay out of pocket.
No, we do not accept or bill medical insurance. All our services are billed as dental procedures through dental insurance only.
Yes. Health Savings Accounts and Flexible Spending Accounts are accepted for all our procedures, which are eligible medical expenses.
We accept self-pay patients. Treatment fees are the same as posted above. CareCredit financing is available if you'd like to pay over 6, 12, or 18 months at 0% interest.
Every dental procedure is identified by a short alphanumeric code from the ADA's Current Dental Terminology (CDT) — the universal billing language between dental offices and insurance companies. We've written a plain-English explainer of the endodontic codes you'll most often see (D3310 anterior root canal, D3320 premolar, D3330 molar, D3346/D3347/D3348 retreatment, D3410/D3425 apicoectomy, D0367 CBCT, D9230 nitrous oxide):
Bring your insurance card to your consultation, or share it with our front office in advance. We'll verify your benefits and give you a written cost estimate before any treatment begins.