As no two of us are alike, and there is not a standard price for braces as the time and complexity of treatment varies significantly from one person to the next. The orthodontist will need to evaluate the patient and their needs before setting a fee for the treatment. The average treatment with braces takes 2 to 3 years and in San Diego costs $8540.00 according to www.bracesinfo.com for June 2015. (Their most recent information). A survey of local orthodontists places the average closer to $6800.00. The range around this average is wide, from $3400.00 – $ 9600.00.
This is a price with no insurance involved. San Diego is home to many types of insurance plans, PPO, HMO and Discount only.
PPO and HMO plans limit specific parts of the fee and often do not include numerous items/services which are required, but not covered. The required services are charged at the regular price and added to the discounted insurance fee. The covered fee is usually for braces on the upper and lower teeth for 24 months of adjustments. Often excluded are the diagnostic records, palate expander devices, bite planes (anterior bite opening devices), treatment lasting longer than 24 months, retainers and retainer adjustments. In addition, HMO plans require the patient to see one of the contracted providers. The primary dentist usually needs to make a referral. If the patients is treated by a non-contracted dentist, the insurance discounted fee does not apply. PPO plans recommend the patient be treated by a contracted provider, but it is not required. The contracted providers will usually offer a lower price for treatment than the non-contracted providers.
Discount only plans do not pay any money to the Orthodontist, they only offer a discounted fee on a specific part of the treatment IE: Placing braces and 24 adjustments. All other parts of the treatment IE: Diagnostic records, retainers, palate expanders, etc. are not a covered benefit.
Qualifying with the HLD Index is required by some plans. The HLD Index is a scoring device used to determine if a malocclusion (bite problem) is medically handicapping. The usual qualifying score for the HDL Index is 26 or more points.