- Root Canal TreatmentMac-type dental plans pay the provider the same contracted fee for covered services whether they are in or out of network and is lower than the PPO fees. Staying in-network is a key component in this type of plan to receive a cost-effective benefit. The charge per procedure is negotiated between Cypress and the in-network provider. Out-of-network dentists are not subject to the contracted fees and can charge the member higher fees for services, while the member’s dental plan pays the dentist the same amount as the in-network provider, and balance bills the patient for the remaining amount. For example, the out-of-network dentists charges $1500 for a root canal, and the plan covers the procedure at 50%. The member’s in-network negotiated fee is $900, so the plan will pay $450 toward the $1500 procedure. The member would be responsible for a balance of $1050. MAC Plans have lower monthly premiums and fit well for employers who have employees visiting contracted in-network providers.
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