Average dental charges 2011
The information contained in Table 1 – 'Average dental charges for privately insured services in 2011' has been collected by the Department of Health and Ageing, and publicly released to help consumers make more informed decisions when purchasing services and encourage greater competition in the private health industry.
In 2010-11, private health insurers paid $1.65 billion for dental services of the $3.22 billion they paid for all general treatment services. Insurers pay more benefits for dental services than any other type of general treatment, amounting to almost 51%, followed by optical at 18%. While consumers are aware of gaps between dental charges and the amount paid by their health insurer, there is little information available about average dental charges.
Guide to Dental Services Reported
Table 1 contains a list of 21 common dental services by the Australian Dental Association (ADA) code and the average charge within each state/territory based on consumers place of residence. It is important to note that charges within each state/territory will vary depending on location. (eg. major city, inner regional or remote).
A description of each item can be found in Table 2 – 'Description of ADA Code'. Table 2 segments each ADA code into the following categories of dentistry:
- Diagnostic
- Preventative
- Oral Surgery
- Restorative
- Crowns
This list of dental services may be expanded in the future, depending on data availability and consumer demands.
Origin of Data
De-identified data was provided by private health insurers to the Department of Health and Ageing for the following dental services provided to privately insured patients in 2011, which was obtained as part of the claiming process.
Table 1 - Average dental charges for privately insured services during 2011
| ADA Code | NSW/ACT | NT | QLD | SA | TAS | VIC | WA | National Average |
|---|---|---|---|---|---|---|---|---|
| 011 | $54.42 | $65.53 | $55.10 | $51.98 | $58.10 | $53.68 | $55.64 | $54.57 |
| 012 | $51.21 | $58.16 | $48.79 | $47.86 | $54.50 | $48.38 | $50.05 | $49.75 |
| 013 | $45.13 | $56.40 | $41.55 | $44.47 | $44.39 | $42.17 | $44.50 | $43.79 |
| 014 | $58.42 | $68.90 | $54.31 | $55.11 | $57.32 | $56.43 | $57.97 | $56.95 |
| 022 | $38.42 | $43.05 | $38.14 | $40.82 | $38.85 | $45.49 | $40.10 | $40.11 |
| 071 | $58.25 | $51.34 | $50.56 | $56.57 | $55.78 | $56.56 | $58.36 | $56.28 |
| 111 | $54.34 | $73.12 | $52.34 | $55.62 | $53.14 | $49.62 | $57.65 | $53.14 |
| 114 | $96.19 | $123.73 | $95.98 | $98.55 | $95.93 | $105.99 | $99.92 | $99.04 |
| 121 | $33.01 | $28.26 | $27.86 | $28.99 | $30.77 | $29.42 | $30.35 | $30.71 |
| 161 | $48.37 | $64.51 | $50.21 | $43.14 | $44.20 | $48.43 | $53.20 | $48.72 |
| 311 | $149.32 | $160.80 | $145.92 | $130.66 | $158.23 | $139.17 | $141.94 | $144.22 |
| 521 | $122.54 | $136.54 | $120.82 | $112.38 | $136.43 | $122.43 | $119.37 | $121.23 |
| 522 | $154.61 | $164.21 | $146.91 | $138.96 | $162.65 | $147.02 | $144.65 | $148.73 |
| 523 | $175.57 | $201.90 | $172.02 | $160.38 | $186.40 | $165.54 | $168.54 | $170.76 |
| 531 | $128.53 | $146.89 | $127.05 | $121.81 | $140.51 | $127.43 | $131.85 | $128.22 |
| 532 | $169.77 | $183.08 | $162.28 | $155.69 | $176.73 | $161.23 | $169.56 | $165.31 |
| 533 | $196.43 | $226.27 | $193.64 | $188.99 | $203.31 | $189.61 | $199.51 | $194.47 |
| 534 | $216.95 | $270.73 | $216.40 | $205.77 | $228.50 | $207.75 | $220.42 | $214.82 |
| 575 | $30.43 | $34.34 | $29.80 | $28.24 | $27.87 | $30.86 | $30.66 | $30.06 |
| 577 | $32.12 | $37.74 | $31.38 | $29.29 | $30.86 | $30.69 | $37.90 | $31.88 |
| 615 | $1,365.66 | $1,494.65 | $1,395.82 | $1,340.62 | $1,452.15 | $1,395.33 | $1,316.79 | $1,366.23 |
Table 2 - ADA code descriptions
| ADA Code | Description | Category |
|---|---|---|
| 011 | Comprehensive oral examination | Diagnostic |
| 012 | Periodic oral examination | |
| 013 | Oral examination – limited | |
| 014 | Consultation | |
| 022 | Intraoral periapical or bitewing radiograph - per exposure | |
| 071 | Diagnostic model – per model | |
| 111 | Removal of plaque and/or stain. | Preventative |
| 114 | Removal of calculus - first visit | |
| 121 | Topical application of remineralising and/or cariostatic agents, one treatment | |
| 161 | Fissure sealing - per tooth | |
| 311 | Removal of a tooth or part(s) thereof | Oral Surgery |
| 521 | Adhesive restoration – one surface – anterior tooth – direct | Restorative |
| 522 | Adhesive restoration – two surfaces – anterior tooth – direct | |
| 523 | Adhesive restoration – three surfaces – anterior tooth – direct | |
| 531 | Adhesive restoration – one surface – posterior tooth – direct | |
| 532 | Adhesive restoration – two surfaces – posterior tooth – direct | |
| 533 | Adhesive restoration – three surfaces – posterior tooth – direct | |
| 534 | Adhesive restoration – four surfaces – posterior tooth – direct | |
| 575 | Pin retention – per pin | |
| 577 | Cusp capping – per cusp | |
| 615 | Full crown - veneered – indirect | Crowns |

