Real Dental Costs Data Brief, Episode One: What Medicaid Pays Dentists for a Crown, State by State

The data behind this episode

Every figure spoken in the episode comes from the State Medicaid Dental Fee Index 2026. The same table is below, so you can check any state while you listen.

Transcript

This is the Real Dental Costs Data Brief, from the Real Dental Costs Data and Research Team. Each episode takes one dataset off our desk and goes through what it measures, what it does not measure, and where the numbers came from. This one is the State Medicaid Dental Fee Index 2026.

Start with the definition, because it decides how everything else should be read. The index compiles state Medicaid dental fee-for-service schedules across 51 jurisdictions, every state plus the District of Columbia. A fee schedule amount is the rate a state Medicaid program publishes for paying a dentist for a procedure. It is not a patient price. It is not a bill, it is not an estimate of what someone pays at the front desk, and it is not what a managed care dental plan pays a practice. Managed care payer rates are excluded from this index by design. So when a dollar figure comes up in the next few minutes, read it as a program rate paid to a provider.

We track four procedure codes, and we use our own plain labels for them. D2740, a porcelain or ceramic crown. D3330, a molar root canal. D5110, a complete upper denture. D2950, a core buildup. Every ranked amount is the adult, general dentist rate in force in that state's schedule.

Take the crown first. Across the 34 jurisdictions that list a paying adult fee for D2740, the median is $552.40. The lowest is $272.83, in Illinois. The highest is $1,512.65, in Delaware. That is a factor of 5.5 for the same code. Nothing about the tooth changes at a state line. The published rate does.

The molar root canal follows the same shape. 36 jurisdictions list a paying adult fee for D3330. The median is $530.84, running from $234.67 in Illinois to $1,173.04 in Delaware, a factor of 5.0.

The complete upper denture is the most widely listed of the four. 42 jurisdictions carry a paying adult fee for D5110, with a median of $730.00, from $311.37 in Florida to $2,083.26 in Delaware, a factor of 6.7.

The widest spread sits on the smallest procedure. The core buildup, D2950, has a paying adult fee in 32 jurisdictions. The median is $133.39, and the range runs from $49.50 in New Jersey to $361.24 in Delaware. That is a factor of 7.3, on a supporting step that is often billed alongside a crown.

Now the part that gets lost when a single number travels on its own. A missing state is not a cheap state. On the crown code, 8 jurisdictions do not list D2740 at all in the schedule we compiled, and 7 more price it only for ages zero to twenty, on a children's schedule. Those are not ranked and not counted in the median. A code that is absent tells you the schedule does not carry it. It does not tell you what a program covers, and it does not tell you what any patient would face.

Next, the difference between what a program publishes and what a program paid. For that we bring in the HHS and CMS Medicaid provider spending file built on T-MSIS, 2024 preliminary figures. Across the country, the published cells work out to $544.98 paid per claim line for the crown, $518.40 for the molar root canal, $487.74 for the complete upper denture, and $115.57 for the core buildup.

Treat that comparison as exploratory rather than like for like. The state on a claim line is assigned from the servicing provider's practice address, not the beneficiary's state and not the paying program. Small cells are suppressed at the source. We drop state and code cells with fewer than 10 dentists represented, and we drop five states flagged for unreliable encounter amounts: Arizona, Florida, Michigan, Oregon and Virginia. After those filters, only 16 states are comparable on the crown, and in 8 of them the paid per line figure sits above the schedule fee. Illinois is the clearest case: a schedule fee of $272.83 against $450.35 paid per line, a ratio of 1.65. On the root canal, Minnesota shows $271.40 on the schedule against $686.78 paid, a ratio of 2.53. Those gaps are a prompt to go look at the state, not a finding on their own.

One more caution, on dates. We hold 51 source schedule records. 37 carry a stored 2026 date, 2 carry a date from the second half of 2025, and 8 have no document level date available at all. A stored date may be an effective date, an as of date, or a revision date, so it is not a uniform measure of when every code last changed.

We also ran two source checks worth naming, because they show how much the choice of source document matters. In Arizona, the capped fee schedule workbook effective October 1, 2026 adds 8 dental codes that were previously paid By Report, a change announced in a state notice dated August 17, 2026. For 3 of those codes, the notice and the workbook disagree with each other. Against a secondary compiled index, 0 of 332 codes compared differed. The index uses the workbook amounts. In Wisconsin, the state's primary maximum fee extract was compared with a secondary compiled index as of September 1, 2025. 88 codes differ, 73 match, and the largest single difference is $168.94. 126 codes appear only in the primary extract, including the crown code D2740. The index uses the state extract.

So what is this for. If you are a reporter, a state analyst or a researcher, the useful move is not the national headline number. It is the state row, with its source document, its scope and its date sitting next to it. The full table, the chart and the per state sources are at realdentalcosts.com/en/medicaid-dental-fee-index-2026/. Our compilation, our labels and our calculations are published under CC BY 4.0, so you can republish them with credit, while the underlying source documents stay subject to their own terms. The data in this episode is as of September 14, 2026.

That is the brief. This is pricing and market research, not medical or insurance advice.

Data and reuse

• Dataset, interactive table and per state sources: State Medicaid Dental Fee Index 2026
• How we compile and check the figures: methodology
• Citation and reuse terms: cite this data. CC BY 4.0 covers the Real Dental Costs compilation, original labels and calculations; source documents keep their own terms.
• Found an error in a figure? Report a data correction.