| 1 | Dental examination with the use of intra-oral camera | 50 PLN |
| 2 | Dental filling with photo-cured composite material (CERAM X, Empres Direct) | |
| - one surface | 90 PLN | |
| - two surfaces | 100 PLN | |
| - three surfaces MOD | 110 PLN | |
| - tooth reconstruction | 150 PLN | |
| - composite restoration | 150 PLN | |
| 3 | Healing dressing | 50 PLN |
| 4 | Dental pulp devitalisation | 50 PLN |
| 5 | Dental pulp extirpation | 50 PLN |
| 6 | Local anaesthesia | 20 PLN |
| 7 | Root canal treatment | |
| -one root canal filling | 150 PLN | |
| -two root canals filling | 200 PLN | |
| -three and more root canals filling | 300 PLN | |
| 8 | Root canal temporary filling | 50 PLN |
| 9 | Dead tooth bleaching (one appointment) | 40 PLN |
| 10 | Teeth bleaching (teeth-bearer applied at home or in the surgery) | 700 PLN |
| 11 | Application of dental jewellery | 150 PLN |
| 1 | Surgical consultations | 50 PLN |
| 2 | Tooth extraction | 100 PLN |
| 3 | Tooth extraction with chiseling | 150 PLN |
| 4 | Retained tooth extraction | 300 PLN |
| 5 | Primary tooth extraction | 50 PLN |
| 6 | Oronasal fistula closure | 200-250 PLN |
| 7 | Root apex resection | |
| -one-rooted tooth | 300-400 PLN | |
| -multi-rooted tooth | 600 PLN | |
| 8 | Alveoloplasty | 150 PLN |
| 9 | Alveolus sewing | 50 PLN |
| 10 | Abscess incision | 50 PLN |
| 11 | Plastic reconstruction of frenulum | 120 PLN |
| 12 | Histopathological examination | 150 PLN |
| 13 | Dry socket treatment | 50 PLN |
| 14 | Vestibular deepening | 150 PLN |
| 15 | Implant | |
| -surgical part | 2500 PLN | |
| -prosthetic part | 2000 PLN |
| 1 | Prosthetic consultations | 50 PLN |
| 2 | Full denture | 500 PLN |
| 3 | Denture relining | 200 PLN |
| 4 | Denture strengthening net | 100 PLN |
| 5 | Denture strengthening arch | 100 PLN |
| 6 | Acrylic partial denture | 450 PLN |
| 7 | Immediate partial denture | 500 PLN |
| 8 | Immediate complete denture | 450 PLN |
| 9 | Denture repair | 60 PLN |
| 10 | Skeletal denture | 1200 PLN |
| 11 | Acetal denture | 1200 PLN |
| 12 | Splint denture | 700 PLN |
| 13 | Porcelain fused to metal crown | 500 PLN |
| 14 | Zirconia-based all-ceramic crown (LAVA) | 1200 PLN |
| 15 | All-ceramic crown | 1000 PLN |
| 16 | Temporary crown | 50 PLN |
| 17 | Cementation of crown prepared outside the surgery | 50 PLN |
| 18 | Crown / bridge removal (one point) | 50 PLN |
| 19 | Porcelain fused to metal bridge (one point) | 500 PLN |
| 20 | Zirconia-based all-ceramic bridge (LAVA) (one point) | 1200 PLN |
| 21 | All-ceramic bridge | 1000 PLN |
| 22 | Composite adhesive bridge (one point) | 200 PLN |
| 23 | Crown-root inlay (metal, fiberglass) | 150 PLN |
| 24 | Composite onlay | 250 PLN |
| 25 | All-ceramic inlay | 500 PLN |
| 26 | Relaxation splint | 200 PLN |
| 27 | Composite veneer | 300 PLN |
| 28 | Porcelain veneer | 500 PLN |
| 1 | Scaling | 100 PLN |
| 2 | Sandblasting | 150 PLN |
| 3 | Fluoridation | 50 PLN |
| 4 | Fissure sealing | 50 PLN |
| 5 | Teeth splinting with the use of fiberglass (one tooth) | 80 PLN |
| 1 | Teeth lacquering | 50 PLN |
| 2 | Fissure sealing | 50 PLN |
| 3 | Primary tooth extraction | 50 PLN |
| 4 | Primary tooth filling (FUJI IX, TWINKY STAR, CERAM X) | 75 PLN |
