Charges online publicity list
Unit name: Shanghai Pacific Stomatological Medical Center
No. Item name Billing unit Charging standard Remarks
General outpatient registration fee times 3.00 "general outpatient
charges"
002 Inspection and diagnosis fee times 10.00
003 Medical Disposables Set 10.00
0083a Denture Repair Small Tray 25.00
0083b Denture Repair Medium Tray 40.00
0083c Denture Repair Large Tray 50.00
0083d Additional Lining Half Mouth 100.00
0084 Artificial Teeth 15.00 only.
0084a Artificial tooth (high strength resin) only 25.00
0087 Disposable finished tray 7.00
0088 Individual tray 50.00
0094 Removal of defective restoration 50.00
0103 High strength resin tooth (full denture) full mouth 1500.00 " General Outpatient
Rates
Half-port reduction"
0111 Plastic Partial Denture (1-3) 250.00 "General Outpatient
Rates"
0112 Plastic Partial Denture (4-6) 360.00
0113 Plastic Partial Denture (7-9) 500.00
0114 Plastic Partial Denture (10-13) Piece 600.00
0131 Double Palatal Bar Piece 600.00
0132 Ken's Bar Piece 600.00
0133 Full Base Plate Piece 600.00
0134 Horseshoe Base Plate Piece 600.00
0135 Single Palatal Bar Piece 600.00
0135 Single palatal bar piece 600.00
0136 Tongue plate or bar piece 600.00
0137 Saddle shaped base plate piece 360.00
0138 Integral cast tooth 150.00 per tooth
0141 Non-precious metal porcelain 550.00 per tooth
0142 50% gold alloy porcelain 1000.00 per tooth
0143 50% gold alloy cast crowns 1000.00 per tooth
0144 50% gold alloy piles 300.00
0144a Pile cores Roots 300.00
0145 Porcelain rims 100.00 per tooth
0147 Non-precious metal cast core 120.00 per tooth
0148 Resin Finished Nail Core Root 100.00
0149 80% Gold Alloy Porcelain Crown 1800.00 per tooth
014a 80% Gold Alloy Casting Crown 1800.00 per tooth
014b All Porcelain Crown 2250.00 per tooth
203 Dental Film 25.00
205 Panoramic Film 50.00 "General Outpatient
Rates"
301 必兰麻醉 次 10.00
310 一般口腔治療牙 10.00
311 银汞充填牙 50.00
312 进口树脂充填牙 80.00 <
321 Pulp Drying Tooth 80.00
331 Root Canal Cleaning Enlargement Root 40.00
332 Root Canal Exchange 10.00
333 Root Filling Root 30.00
334 Root Removal Root Filling Root 50.00
341 Threaded Nail Root 10.00
342 Tooth Bleaching Full Mouth 300.00
350 Sandblasting Decolorization Full Mouth 100.00
351 Ultrasonic Supragingival Cleaning Full Mouth 100.00
352 Root Canal Nail Root 15.00
353 Fistula Passage Tooth 15.00
354 Endocervical Scaling Tooth 10.00
355 Oral Surgery Extractions 50.00
360 Extractions of milk teeth Tooth 5.00
361 Extractions of permanent teeth Tooth 50.00
362 Extractions of residual roots and crowns Tooth 100.00
365 Extractions of blocked teeth Tooth 200.00
367 Alveolar bone revision Zone 100.00 "General Outpatient Clinic
Charges
Full mouth in 4 zones"
368 Apicoectomy Session 100.00 "General Outpatient
Charges"
369 Abscess Incision (Intra-oral) Session 25.00
Special Needs Clinic Registration Fee Session 6.00 "Special Needs Clinic
Charges"
4001 Examination Consultation Fee 15.00
4002 Disposable Medical Sterilization Kit 10.00
4003 General Oral Treatment 20.00
4004 Minor Oral Surgery Area 50.00
4005 Ultrasonic Sandblast Cleaning Whole Mouth 200.00
4006 Silver Mercury Filling Teeth 100.00
4007 Imported Dental Filling Fillings
4007 Imported Resin Filling Tooth 200.00
4008 Pulp Disease Treatment Tooth 200.00
4009 Root Canal Treatment of Anterior Tooth 300.00
4010 Root Canal Treatment of Posterior Tooth 500.00
4011 Oral Surgery Session 300.00
4012 Local Anesthesia Session 10.00 "Special Needs Clinic
Fee Schedule"
4021 Dental Implant Surgery Tooth 1000.00
4061 Extraction of Breast Tooth Tooth 5.00
4062 Extraction of Permanent Tooth Tooth 100.00
4063 Orthodontic Decimalization and Extraction Tooth 50.00
4064 Residual Root and Crown, Fractured tooth extraction Tooth 200.00
4065 Obstructed tooth extraction Tooth 400.00
4091 Dental X-ray Sheet 25.00
4093 Panoramic film Sheet 50.00
4201 Removal of defective restorations Tooth 100.00
4202 Palladium gold crowns/porcelain teeth Per tooth 1600.00
4202 Orthodontic reduction extractions Tooth 100.00
4203 Orthodontic reduction extractions 1600.00
4203 50% Gold Crown/Porcelain 1500.00 per tooth
4204 80% Gold Crown/Porcelain 2500.00 per tooth
4211 All Porcelain Crown 2250.00 per tooth
4221 Porcelain Margins/Implanted Gum 160.00 per tooth
4231 Porcelain inlay 1300.00 per tooth
4232 80% gold inlay 1300.00 per tooth
4241 Casting core root 310.00
4241a Core root 310.00
4242 Finished core/pile root 120.00
4243 Diagnostic wax-up per tooth 150.00
4244 Provisional Crown 300.00
4245 3M Pre-Formed Crown 50.00
4301 Full Base Plate Piece 920.00
4302 Single Palatal Bar Piece 920.00
4303 Horseshoe Base Plate Piece 920.00
4304 Lingual Plate or Tongue Rods 920.00
4305 Double Palate Rods 1050.00
4306 Ken's Rods 1050.00
4307 Horseshoe Base Plates 690.00
4401 Arrangement of Teeth (1-3 teeth) 550.00
4402 Arrangement of Teeth (4-8 teeth) 830.00
4403 Arrangement of teeth (9-13 teeth) times 1100.00
4404 Artificial teeth row 100.00
4501 Full mouth plastic denture full mouth 5500.00 "Special Needs Clinic
Fees
Half port half fee"
4601 Plastic Individual trays vice 100.00 "Special Needs Outpatient
Fee Schedule"
4602 Facial Arch Recording (Upper or Lower) Sub 280.00
4603 Sphere Hat Precision Body Fittings Set 1560.00 "Special Needs Outpatient
Fee Schedule"
4604 Magnetic Precision Body Fittings Set 2370.00
4606 ITI Implant Material Teeth 8500.00
4606c Dental Implants Phase II Restorations Tooth 5500.00
4607 Transparent Attachment (Upper or Lower) Piece 120.00
4608 Non-Friable Adhesive Attachment (Upper or Lower) Piece 170.00
4609 Denture D-Card Piece 140.00
4610 Adhesive Tray Closure Support piece 400.00
601 First visit examination, diagnosis and comprehensive design 500.00
613 Teenage fixed orthodontics first fee (full mouth) 5000.00 half-port halving fee
614 Teenage fixed orthodontics follow-up fee (full mouth) 250.00 half-port halving fee
631 Clarity (3-3) Ceramic Brackets Pay 4000.00 Additional charge for this material
632 Clarity (5-5) Ceramic Brackets Pay 5000.00
633 Lingual Fixed Appliances Pay 10000.00
641 Initial Functional Orthodontics Fee for Children (Full Mouth) Pay 3000.00 Half Mouth Half fee
642 Functional orthodontic appliance for children (full mouth) 300.00 half fee
643 Functional orthodontic appliance for children (full mouth) 1,500.00 half fee
653 Fixed orthodontic appliance for adults and difficult to treat first time (full mouth) 6500.00 half fee
654 Fixed orthodontic appliance for adults and difficult to treat first time (full mouth) 6500.00 half fee
654 Fixed orthodontic appliance for adults and difficult to treat first time (full mouth) 6500.00 half fee
654 Fixed orthodontic appliance for adults and difficult to treat first time (half fee) p>654 Adult and difficult fixed orthodontic treatment follow-up fee (full mouth) 325.00 half-oral half-fee
691 Fixed orthodontic repairs 100.00
692 Removable orthodontic treatment, retainer 300.00 half-oral half-fee
693 CLARITY ceramic bracket fractional piece 350.00