Is There Such a Thing As a "Crown Upgrade"? I'm Being Charged an Extra $300 Because of This.

In dentistry, unlike other service areas, the fees quoted usually are all inclusive and carry the best outcomes a particular clinician can provide.  In some instances where material and laboratory craftsmanship is paramount certain clinician may elect to use premium laboratory services which may carry a higher fee therefore the "upgrade".  So say the lab fee for the average crown is $150 for a production lab porcelain fused to metal.  A premium lab with a master ceramist may charge upwards of $500 for a product that may not be differentiated from natural tooth by the untrained eye.  So if that's what you want you pay more.  

That being said some doctors make a choice to always offer premium service and as a result make an effort to always provide the best to all patients.  

Some crowns just cost more to fabricate.  At my office, we don't necessarily call it an upgrade fee.  As with most things, you get what you pay for.  If you are looking for better asthetics you will often pay a little more than if you are just looking to make a fix.  We make sure we inform the patient of any fee differences and the reasons before their scheduled appointment though, as your office should have.

You may not be aware of this but ins. company have different fee structures for reimbursment for all ceramic crowns, zircronia crowns, all metal crowns, such as noble metal, semiprecious, and base metal, composite crowns, titanium crowns, acrylic crowns and the list goes on, you should no the type of crown and ins. code many dentist have a different fee for each type since ins. companies pay different amounts. Each material has disadvantages and advantages along with cosmetic properties and strengths talk to your dentist about these issues before the crown is constructed good luck.

 

Kevin Coughlin DMD, MBA, MAGD    CEO Baystate Dental PC

I have seen this before, but only when going to a managed care facility or subsidized clinic.  These places advertise low fees to get people in the door, but the reality of costs and overhead affect them as well, and the only way to make ends meet requires fee supplementation that insurance doesn't cover.

 

The end result is that the out of pocket costs to be seen in these offices end up being about the same, but the quality of care can be unpredictable.

Yes, there is such a thing as a crown upgrade charge.  In our office, we work with several different dental labs ranging in quality from good, to better, to best.  It's similar to purchasing a car.  If you opt for the base model you will pay the base price.  If you go with a higher quality lab with superior materials, you generally will pay an upgrade fee.  The reason you may not have encountered this in your previous offices is if they only used one lab, or only gave one option for crowns.  An all-porcelain crown is going to be more expensive than a PFM, or porcelain fused to metal.  I would recommend discussing this with your office to see what the exact reasons are for them charging the upgrade fee.  Are you getting a higher quality crown?  Is it an upgraded lab they are using?  Why does the dentist feel this type of crown will be better for you?  You can also make sure there is documentation that the office has given you the crown you paid for.  Good luck!