Without state insurance | State-insured person under 18 years of age | State-insured person over 18 years of age | |
|---|---|---|---|
| Primary or preventive examination | 500 Kč | covered by insurance paid once a year | covered by insurance paid once a year |
| Consultation (up to 20 minutes) | 500 Kč | 500 Kč | 500 Kč |
| Digital X-ray | 500 Kč | covered by insurance paid once every two years | covered by insurance paid once every two years |
| CBCT | 1 200 Kč | 1 200 Kč | 1 200 Kč |
| Local anesthesia | 500 Kč | covered by insurance covered by insurance | covered by insurance covered by insurance |
| Rubber dam | 500 Kč | 500 Kč | 500 Kč |
| Optragate | 500 Kč | 500 Kč | 500 Kč |
| Devitalization | 500 Kč | 500 Kč | 500 Kč |
| Temporary filling | 500 Kč | 500 Kč | 500 Kč |
| Child non-cooperation (10 minutes or more) | from 500 Kč | from 500 Kč | from 500 Kč |
| Dental hygiene (Ultrasound + AirFlow) | 1 800 Kč | 1 800 Kč | 1 800 Kč |
| Fissure sealing | 1 500 Kč | 1 500 Kč | 1 500 Kč |
| Composite filling | 2 000 Kč - 3 000 Kč | covered by insurance covered by insurance (once per year, surcharge for rubber dam required, treatment without rubber dam is not allowed) | from 2 000 Kč 900 CZK covered once every two years |
| Extensive tooth reconstruction | 3 500 Kč | covered by insurance covered by insurance (once per year, surcharge for rubber dam required) | 3 500 Kč 900 CZK covered once every two years |
| Composite veneer | 3 000 Kč | 3 000 Kč | 3 000 Kč |
| Medical liner Ultra-Blend plus | 500 Kč | 500 Kč | 500 Kč |
| Tooth reconstruction after endodontic treatment with FRC post | 4 000 Kč | covered by insurance covered by insurance + 1,500 CZK for FRC post (once per year) | 4 000 Kč 900 CZK covered once every two years |
| Icon (1 tooth) | from 2 000 Kč | from 2 000 Kč | from 2 000 Kč |
| In-office whitening Opalescence Boost | 6 000 Kč | 6 000 Kč | 6 000 Kč |
| Combined whitening Pure Whitening | 9 500 Kč | 9 500 Kč | 9 500 Kč |
| Tooth extraction | 500 Kč - 6 000 Kč | 500 Kč - 6 000 Kč | 500 Kč - 6 000 Kč |
| Suture removal | 500 Kč | 500 Kč | 500 Kč |
| Incision | 1 000 Kč - 2 000 Kč | 1 000 Kč - 2 000 Kč | 1 000 Kč - 2 000 Kč |
| Treatment under analgosedation – Midazolam | 2 000 Kč | 2 000 Kč | 2 000 Kč |
| 3D scan | 1 000 Kč | 1 000 Kč | 1 000 Kč |
| Implant placement | from 16 500 Kč | from 16 500 Kč | from 16 500 Kč |
| Sinus lift | 6 000 Kč - 10 000 Kč | 6 000 Kč - 10 000 Kč | 6 000 Kč - 10 000 Kč |
| Gum surgery | 1 000 Kč - 5 000 Kč | 1 000 Kč - 5 000 Kč | 1 000 Kč - 5 000 Kč |
| Surgical guide for implants | 2 000 Kč - 5 000 Kč | 2 000 Kč - 5 000 Kč | 2 000 Kč - 5 000 Kč |
| Penalty for missed appointment (24 hours) | from 500 Kč | from 500 Kč | from 500 Kč |
| Medical record extract | from 500 Kč | from 500 Kč | from 500 Kč |
Without state insurance | State-insured person | |
|---|---|---|
| Rubber dam | 500 Kč | 500 Kč |
| Optragate | 500 Kč | 500 Kč |
| Devitalization | 500 Kč | 500 Kč |
| Temporary filling | 500 Kč | 500 Kč |
| Extraction of a primary tooth | 500 Kč | 500 Kč |
| Dental hygiene of primary teeth | 1 500 Kč | 1 500 Kč |
| Composite filling on primary tooth | 1 500 Kč | covered by insurance covered by insurance (once per year, surcharge for rubber dam required, treatment without rubber dam is not allowed) |
| Endodontic treatment of a primary tooth | 2 000 Kč | covered by insurance covered by insurance (once, surcharge for rubber dam required) |
| Re-endodontic treatment of a primary tooth | 2 500 Kč | 2 500 Kč |
| (Ca replacement) | 500 Kč | 500 Kč |
| Treatment under analgosedation – Midazolam | 2 000 Kč | 2 000 Kč |
| Child non-cooperation (10 minutes or more) | from 500 Kč | from 500 Kč |
Without state insurance | State-insured under 18 | State-insured over 18 | |
|---|---|---|---|
| Consultation after CBCT | 500 Kč | 500 Kč | 500 Kč |
| Microscopic examination | 1 000 Kč | 1 000 Kč | 1 000 Kč |
| Post removal | 500 Kč - 2 000 Kč | 500 Kč - 2 000 Kč | 500 Kč - 2 000 Kč |
| Denticle removal | 500 Kč - 2 000 Kč | 500 Kč - 2 000 Kč | 500 Kč - 2 000 Kč |
| Tooth trepanation | 500 Kč | 500 Kč | 500 Kč |
| Trepanation with canal enlargement | 2 000 Kč | 2 000 Kč | 2 000 Kč |
| Build-up | 500 Kč | 500 Kč | 500 Kč |
| Composite filling after endo | 2 500 Kč - 3 500 Kč | covered by insurance covered by insurance, rubber dam surcharge required | 2 500 Kč - 3 500 Kč 900 CZK covered once every two years |
| Gum resection | 500 Kč | 500 Kč | 500 Kč |
| Endodontic treatment: | |||
| Treatment under microscope | 1 000 Kč | 1 000 Kč | 1 000 Kč |
| 1 canal (tooth 3-3) | 4 500 Kč | covered by insurance covered by insurance (rubber dam surcharge required, treatment without it not allowed) | 4 500 Kč 1300 CZK covered by insurance |
| 2 canals (tooth 5-5) | 5 500 Kč | covered by insurance covered by insurance (rubber dam surcharge required, treatment without it not allowed) | 5 500 Kč 2600 CZK covered by insurance |
| 3 canals (teeth 6,7,8) | 6 500 Kč | covered by insurance covered by insurance (rubber dam surcharge required, treatment without it not allowed) | 6 500 Kč not covered by insurance |
| 4 canals (teeth 6,7,8) | 7 000 Kč | covered by insurance covered by insurance (rubber dam surcharge required, treatment without it not allowed) | 7 000 Kč not covered by insurance |
| plus Ca | 1 500 Kč | covered by insurance covered by insurance (rubber dam surcharge required) | 1 500 Kč |
| (Ca replacement) | 500 Kč | covered by insurance covered by insurance (rubber dam surcharge required) | 500 Kč |
| Re-endodontic treatment (not covered by insurance): | |||
| Treatment under microscope | 1 000 Kč | 1 000 Kč | 1 000 Kč |
| 1 canal | 5 500 Kč | 5 500 Kč | 5 500 Kč |
| 2 canals | 6 500 Kč | 6 500 Kč | 6 500 Kč |
| 3 canals | 8 000 Kč | 8 000 Kč | 8 000 Kč |
| 4 canals | 8 500 Kč | 8 500 Kč | 8 500 Kč |
| plus Ca | 1 500 Kč | 1 500 Kč | 1 500 Kč |
| (Ca replacement) | 500 Kč | 500 Kč | 500 Kč |
| Old crown removal | 1 000 Kč - 3 000 Kč |
| Cast post | 4 000 Kč |
| Crown fixation (+ each subsequent unit 400 kč) | 1 200 Kč |
| Crown fixation on temporary material | 800 Kč |
| Crowns: | |
| Metal-ceramic | 8 500 Kč |
| Zirconia | 9 500 Kč |
| Ceramic / multilayer zirconia | 10 500 Kč |
| Temporary crown | 2 000 Kč |
| Composite crown | 4 000 Kč |
| All-ceramic crown on implant | 13 000 Kč - 16 000 Kč |
| Removable acrylic prosthesis: | |
| Partial denture (1 jaw) | covered by insurance |
| Full denture (1 jaw) | covered by insurance |
| Removable prosthesis from deflex: | |
| Partial denture (1 jaw) | 9 500 Kč |
| Full denture (1 jaw) | 9 000 Kč |
| Temporary removable prosthesis: | |
| Partial denture up to 4 teeth | 6 500 Kč |
| Partial denture up to 9 teeth | 8 500 Kč |
| Partial denture from 10 teeth | 9 500 Kč |
| Cap: | |
| For whitening (both jaws) | 4 000 Kč |
| Against bruxism (1 jaw) | 3 500 Kč |
| Retentive (1 jaw) | 3 500 Kč |
