PA · Medicaid tier: limited

Dental costs in Pennsylvania

Modeled Medicaid and private-market estimates for 62 procedures, adjusted by BEA Regional Price Parities (RPP 97.7).

Dental Affordability & Access Score

How affordable and Medicaid-accessible dental care is in Pennsylvania, from 2 of 2 tracked dimensions.

50 F
  • Private-market affordability $805 avg estimate 60/100 · D
  • Medicaid procedure coverage 23 of 62 procedures 40/100 · F

Benchmarked against the 51-state tracked corpus (p10-p90 range per dimension); a higher score means cheaper private-market care and broader adult Medicaid coverage. See how we place states.

State cost verdict

Pennsylvania's modeled uncovered basket is $46,560 (#10 of 51) with coverage breadth #20 (23 of 62 codes). 19 extensive programs sharing 58 covered codes are coverage-breadth #1 of 51, while Hawaii's limited program at $54,042 is uncovered-basket #1 (39 of 62 codes without a Medicaid fee), above Delaware none-tier at $51,300. Iowa extensive is the basket floor at $12,065.

$46,560
Uncovered basket #10
limited
Adult Medicaid tier
23/62
Procedures covered
$805
Avg private est.

Modeled Medicaid figures are ADA HPI-based estimates; confirm benefits with the state program.

Archive split · CDT categories

How 62 tracked procedures in Pennsylvania split by CDT category

Pennsylvania's heaviest tracked CDT bucket is Oral Surgery (8 of 62). Source: procedures.category × procedure_costs.

Uncovered basket vs nearest peers

Modeled cost of procedures without an adult Medicaid estimate in this archive, priced at each state's own private-market level, plus the share of the tracked basket left uncovered against the 51-jurisdiction mean. Bars are the seven closest ABS uncovered-basket peers plus Pennsylvania (LIM · HEAVY lane) - not a fixed national top-ten. Archive completeness and price level, not a treatment recommendation.

LIM nearest uncovered-basket peers

1. Maine$474182. Nevada$474183. Georgia$473154. Pennsylvania$465605. Kansas$463446. Tennessee$462427. Utah$460368. Oklahoma$45782
Seven closest ABS(exposure) jurisdictions to Pennsylvania's modeled uncovered basket, plus this state. Sorted by dollars for the bar board; peer set is state-specific.

Pennsylvania: heavy uncovered share vs corpus

0%100%Corpus mean50%62.9%
Pennsylvania 62.9% · corpus 49.9%
39 of 62 tracked procedures lack a modeled adult Medicaid estimate in Pennsylvania (62.9%). Corpus mean across 51 jurisdictions is 49.9% · delta +13.0 pp.

Source: ADA Health Policy Institute Survey of Dental Fees and Medicaid Reimbursement Compendium; MACPAC adult dental coverage tiers procedure_costs × states coverage_tier join · 2026-05-16 Pennsylvania coverage is MACPAC tier (limited); dollars are modeled private estimates, not billed claims.

Pennsylvania uncovered-basket dollars vs 51 jurisdictions

HEAVY lane · #10 by modeled uncovered basket ($46,560)

$46,560 10th of 51 higher than 41 of 51 jurisdictions

Pennsylvania marked among 51 states

Each bar is a $0.001K-wide band; taller bars hold more jurisdictions. The dashed line + filled bar mark this entry. Hover or tap any bar for its full count and share, and where it sits relative to this entry.

Source ADA HPI × MACPAC coverage join · 2026-05-16

Pennsylvania dental cost table

Pennsylvania mixes modeled Medicaid (23/62) with private estimates. Categories ordered by this state's tracked mix, Oral Surgery heaviest.

Oral Surgery

Procedure CDT Modeled Medicaid Private estimate
Extraction of Erupted Tooth D7140 $65 $208
Incisional Biopsy of Oral Tissue - Soft D7286 Not covered $331
Removal of Impacted Tooth - Bony with Complication D7241 Not covered $490
Removal of Impacted Tooth - Completely Bony D7240 Not covered $423
Removal of Impacted Tooth - Partially Bony D7230 Not covered $361
Removal of Impacted Tooth - Soft Tissue D7220 Not covered $257
Surgical Removal of Erupted Tooth D7210 Not covered $315
Surgical Removal of Residual Tooth Roots D7250 Not covered $388

Diagnostic

Procedure CDT Modeled Medicaid Private estimate
Bitewing Radiographs - Four Films D0274 $26 $74
Comprehensive Oral Evaluation D0150 $34 $110
Intraoral Complete Series of Radiographs D0210 $47 $152
Intraoral Periapical First Radiograph D0220 $13 $34
Limited Oral Evaluation (Problem Focused) D0140 $25 $82
Panoramic Radiographic Image D0330 $46 $135
Periodic Oral Evaluation D0120 $21 $61

Endodontics

Procedure CDT Modeled Medicaid Private estimate
Endodontic Therapy - Anterior Tooth D3310 Not covered $1,050
Endodontic Therapy - Bicuspid Tooth D3320 Not covered $1,223
Endodontic Therapy - Molar Tooth D3330 Not covered $1,454
Retreatment of Previous Root Canal - Anterior D3346 Not covered $1,257
Retreatment of Previous Root Canal - Molar D3348 Not covered $1,574
Therapeutic Pulpotomy D3220 Not covered $171

Prosthodontics

Procedure CDT Modeled Medicaid Private estimate
Complete Denture - Mandibular D5120 Not covered $1,913
Complete Denture - Maxillary D5110 Not covered $1,913
Mandibular Partial Denture - Cast Metal Framework D5214 Not covered $2,058
Maxillary Partial Denture - Cast Metal Framework D5213 Not covered $2,058
Pontic - Porcelain Fused to High Noble Metal D6240 Not covered $1,239
Retainer Crown - Porcelain Fused to High Noble Metal D6750 Not covered $1,239

Adjunctive

Procedure CDT Modeled Medicaid Private estimate
Deep Sedation/General Anesthesia - First 30 Minutes D9220 Not covered $409
Inhalation of Nitrous Oxide / Anxiolysis D9230 $27 $84
Non-Intravenous Conscious Sedation D9248 Not covered $394
Palliative (Emergency) Treatment of Dental Pain D9110 $32 $96
Therapeutic Parenteral Drug - Single Administration D9610 Not covered $75

Implants

Procedure CDT Modeled Medicaid Private estimate
Abutment-Supported Porcelain/Ceramic Crown D6058 Not covered $1,600
Custom Fabricated Abutment D6057 Not covered $675
Implant-Supported Porcelain/Ceramic Crown D6065 Not covered $1,837
Prefabricated Abutment D6056 Not covered $494
Surgical Placement of Implant Body D6010 Not covered $2,304

Preventive

Procedure CDT Modeled Medicaid Private estimate
Prophylaxis - Adult D1110 $41 $120
Prophylaxis - Child D1120 $32 $84
Sealant - Per Tooth D1351 $23 $66
Topical Application of Fluoride D1208 $15 $42
Topical Application of Fluoride Varnish D1206 $16 $45

Crowns

Procedure CDT Modeled Medicaid Private estimate
Crown - Full Cast High Noble Metal D2790 Not covered $1,239
Crown - Porcelain Fused to High Noble Metal D2750 Not covered $1,239
Crown - Porcelain Fused to Noble Metal D2752 Not covered $1,170
Crown - Porcelain/Ceramic D2740 Not covered $1,307

Periodontics

Procedure CDT Modeled Medicaid Private estimate
Gingivectomy or Gingivoplasty - Four+ Teeth D4210 Not covered $447
Periodontal Maintenance D4910 Not covered $164
Periodontal Scaling - 1-3 Teeth Per Quadrant D4342 Not covered $192
Periodontal Scaling - Four+ Teeth Per Quadrant D4341 Not covered $274

Cosmetic

Procedure CDT Modeled Medicaid Private estimate
External Bleaching - Per Arch (Office) D9972 Not covered $441
Internal Bleaching - Per Tooth D9974 Not covered $311

Orthodontics

Procedure CDT Modeled Medicaid Private estimate
Comprehensive Orthodontic Treatment - Adolescent D8080 Not covered $5,924
Comprehensive Orthodontic Treatment - Adult D8090 Not covered $6,351

Pennsylvania uncovered-basket registry (HEAVY)

Modeled uncovered basket $46,560 ranks #10 of 51 (HEAVY lane). Pennsylvania Medicaid covers limited adult dental services (preventive + basic restorative). Pennsylvania has a modeled Medicaid estimate for 23 of 62 tracked procedures (avg $48, ADA HPI models).

BEA RPP 97.7 places Pennsylvania near the national cost-of-living midpoint; private estimates on this page already apply that state multiplier to ADA HPI national averages (factor 0.98). Heaviest tracked CDT bucket: Oral Surgery.

Sources for Pennsylvania: methodology · MACPAC adult dental · BEA RPP · all states · all procedures. Estimates only; not dental advice. As of 2026-05-16.