This is a live sample generated from a fictional practice — "Lakewood Family Dental" in the Dallas metro area. The same engine runs on your real fee schedule when you purchase. Every number here is produced by the actual analysis logic, not a mockup.
Your fee schedule data is never stored
Benchmarks sourced from FAIR Health — the same data carriers use
Lakewood Family Dental
Sample benchmark data · Zip area 752xx · 33 codes analyzed
What this means: Your UCR fees are in the 60–74th percentile range. You have moderate negotiation leverage, but raising your ADJUST and UNDERPRICED codes to the 80th percentile first will significantly strengthen your position. Raise the flagged fees first, establish 6–12 months of billing history at the new rate, then open carrier renegotiations from a position of strength.
Your fee vs. market benchmarks · sorted by revenue opportunity
| Code | Procedure | Your Fee | 50th | 70th | 80th | Gap to 80th | Annual Impact | Status |
|---|---|---|---|---|---|---|---|---|
| D0120 | Periodic oral evaluation | $58 | $50 | $65 | $74 | +$16 | $9,600 | Near Market |
| D0274 | Bitewing radiographic images – four images | $95 | $78 | $102 | $118 | +$23 | $6,900 | Near Market |
| D0210 | Intraoral complete series of radiographic images | $175 | $155 | $200 | $230 | +$55 | $6,600 | Near Market |
| D0150 | Comprehensive oral evaluation | $100 | $88 | $115 | $130 | +$30 | $5,400 | Near Market |
| D0230 | Intraoral periapical each additional image | $28 | $24 | $32 | $37 | +$9 | $5,400 | Near Market |
| D2331 | Resin-based composite – two surfaces, anterior | $210 | $200 | $265 | $300 | +$90 | $5,400 | Below Market |
| D2330 | Resin-based composite – one surface, anterior | $175 | $160 | $210 | $240 | +$65 | $5,200 | Below Market |
| D0330 | Panoramic radiographic image | $175 | $155 | $200 | $230 | +$55 | $4,950 | Near Market |
| D0220 | Intraoral periapical first radiographic image | $35 | $30 | $40 | $46 | +$11 | $4,400 | Near Market |
| D2150 | Amalgam restoration – two surfaces, primary or permanent | $200 | $185 | $240 | $275 | +$75 | $3,375 | Below Market |
| D2140 | Amalgam restoration – one surface, primary or permanent | $160 | $145 | $190 | $215 | +$55 | $3,300 | Below Market |
| D1206 | Topical application of fluoride varnish | $42 | $36 | $48 | $55 | +$13 | $2,600 | Near Market |
| D1351 | Sealant – per tooth | $55 | $48 | $64 | $74 | +$19 | $1,710 | Below Market |
| D1120 | Prophylaxis – child | $95 | $65 | $85 | $98 | +$3 | $360 | At Market |
| D1110 | Prophylaxis – adult | $145 | $95 | $125 | $145 | — | — | At Market |
At Market — your fee is competitive. You can choose to push higher. Near Market — your fee is in range but not maximized. Raising it captures revenue you are currently leaving on the table. Below Market — your fee is below the 50th percentile. Carriers would pay more than you charge — your own fee schedule is the ceiling on your reimbursement.
Raise your fees now
Update your fee schedule to the UCR Ask amounts in the table below. This is what you post — not what you expect to get paid.
Build billing history
Bill at the new rate for 6–12 months before opening carrier negotiations. Carriers evaluate your billing history, not just your current fee schedule.
Negotiate from strength
Carriers rarely move more than 6–9% per cycle. Your UCR Ask is set above the 80th percentile target so that after their standard reduction, you land at or above your goal.
How to calibrate your ask
The data sets the floor. Your competitive position determines the ceiling. Are you the only implant provider in the zip? A boutique practice vs. a high-volume office? These factors justify pushing toward the top of the range. Industry experience suggests that increases beyond 10–15% in a single cycle rarely yield proportional gains — carriers push back harder and the relationship cost outweighs the upside.
Negotiation is an art and a science
No formula guarantees an outcome. The phase plan below is grounded in market data and carrier behavior patterns — but your read of the relationship, your patient mix, and your local market is what closes the gap between the data-driven floor and the maximum achievable increase.
| Code | Procedure | Current | 80th Pct. Target | UCR Ask | Total Gap | Phases | Annual Opp. | |
|---|---|---|---|---|---|---|---|---|
| D2740 | Crown – porcelain/ceramic substrate | $1,280 | $1,650 | $1,800 | +29% | 3 yrs | $20,350 | |
| D2750 | Crown – porcelain fused to high noble metal | $1,220 | $1,600 | $1,745 | +31% | 3 yrs | $15,200 | |
| D0120 | Periodic oral evaluation | $58 | $74 | $80 | +28% | 3 yrs | $9,600 | |
| D2710 | Crown – resin-based composite (indirect) | $980 | $1,300 | $1,415 | +33% | 3 yrs | $9,600 | |
| D2391 | Resin-based composite – one surface, posterior, primary or permanent | $195 | $270 | $295 | +38% | 3 yrs | $9,000 | |
| D2392 | Resin-based composite – two surfaces, posterior, primary or permanent | $240 | $335 | $365 | +40% | 3 yrs | $8,550 | |
| D4341 | Periodontal scaling and root planing – four or more teeth per quadrant | $285 | $390 | $425 | +37% | 3 yrs | $8,400 | |
| D3330 | Endodontic therapy, molar tooth | $1,380 | $1,830 | $1,995 | +33% | 3 yrs | $8,100 | |
| D3310 | Endodontic therapy, anterior tooth | $980 | $1,300 | $1,415 | +33% | 3 yrs | $8,000 | |
| D2790 | Crown – full cast high noble metal | $1,150 | $1,530 | $1,670 | +33% | 3 yrs | $7,600 |
Our Recommendation
Given the gap between your current fees and market benchmarks, we recommend a 3-year phased approach with increases of approximately 11% per cycle. Raise fees now (Phase 1), establish billing history for 6–12 months, then initiate carrier renegotiations. Repeat for each subsequent phase. Practices that skip the billing history step routinely leave 10–20% on the table.
Reading the table: The UCR Ask is what to set your fee schedule to — not what you expect to get paid. The 80th Pct. Target is where you want to land after the carrier negotiates. Phase count is driven by how far below market you are. Click any row to see the year-by-year breakdown.
Your fees are below the market median. Cash patients are likely being undercharged relative to the value you provide. Raising UCR fees will directly improve cash patient revenue and strengthen your negotiation position.
Cash fees and UCR fees are the same number — your posted fee schedule applies to both. Raising your UCR directly improves what uninsured and out-of-network patients pay, and strengthens your position in carrier negotiations simultaneously.
Why This Matters Beyond Your Practice
Your UCR Fees Affect Your Colleagues' Contracts — And Vice Versa
Carriers benchmark reimbursement rates against aggregated UCR data from your zip code. When practices in a market consistently bill low UCR fees, carriers use that data to justify lower reimbursement for everyone in the area. Conversely, practices that maintain fees at the 80th percentile or above pull the market benchmark upward over time. This is not just about your practice — it is about the health of your entire market.
The Sequence Matters
Raising fees and immediately renegotiating is the most common mistake. Carriers evaluate your billing history — a fee that was just raised last month carries far less weight than one billed consistently at that level for 6–12 months. Raise first. Establish history. Then negotiate.