Does Dental Insurance Cover Root Canals? Costs and Coverage

A root canal is one of the most common major dental procedures, with more than 15 million performed in the United States each year. When the soft tissue inside a tooth becomes infected or inflamed, a root canal removes the damaged tissue, cleans the canal, and seals the tooth to prevent further infection. The procedure saves the natural tooth and eliminates the pain caused by the infection.

But root canals are not cheap. Depending on the tooth, the procedure can cost $700 to $1,500, and the crown that typically follows adds another $800 to $1,500. The combined cost of a root canal and crown can easily reach $2,000 to $3,000. Understanding how dental insurance covers these procedures is essential for managing the expense.

This guide breaks down root canal costs by tooth type, explains how dental insurance covers endodontic treatment, and provides strategies for reducing your out-of-pocket expenses. If you are new to dental insurance, you may also want to read our dental insurance guide or our explanation of how dental insurance works.

What Is a Root Canal and When Do You Need One?

A root canal, formally called endodontic therapy, is a procedure to treat infection or damage inside a tooth. Each tooth contains a soft tissue called the pulp, which contains nerves, blood vessels, and connective tissue. When the pulp becomes infected due to deep decay, a cracked tooth, repeated dental procedures on the same tooth, or trauma, a root canal is needed to remove the infected tissue and save the tooth.

Signs that you may need a root canal include severe toothache pain when chewing or applying pressure, prolonged sensitivity to hot or cold temperatures, darkening or discoloration of the tooth, swelling and tenderness in nearby gums, and a persistent pimple on the gums near the affected tooth. If you experience any of these symptoms, see a dentist promptly. Delaying treatment can lead to a dental abscess, which is a more serious and costly condition to treat.

During the procedure, the dentist or endodontist numbs the area, creates an opening in the crown of the tooth, removes the infected pulp, cleans and shapes the root canals, and fills them with a biocompatible material. The opening is then sealed with a temporary or permanent filling. In most cases, a crown is placed over the tooth afterward to protect it and restore its full function.

How Much Does a Root Canal Cost?

The cost of a root canal depends primarily on which tooth needs treatment. Teeth in the front of the mouth have fewer root canals and are simpler to treat, while molars in the back have multiple canals and require more time and skill. Here are the typical price ranges by tooth type.

• Anterior teeth (incisors and canines): $700 to $900. These front teeth have a single root canal, making the procedure faster and less complex. Treatment is typically completed in one visit.
• Premolars (bicuspids): $800 to $1,100. Premolars have one or two root canals. The additional canal makes treatment slightly more involved than anterior teeth.
• Molars: $1,000 to $1,500. Molars have three or four root canals and are located in the back of the mouth where access is more difficult. Molar root canals take longer, often requiring two visits, and are the most expensive.

These prices are for the root canal procedure alone. If an endodontist performs the procedure rather than a general dentist, expect to pay 10% to 30% more. Endodontists are specialists who focus exclusively on root canals and complex cases, and their fees reflect their advanced training. Geographic location also affects pricing, with urban areas and coastal cities tending to charge more than rural areas.

How Dental Insurance Covers Root Canals

Most dental insurance plans organize covered services into three or four tiers: preventive, basic, major, and sometimes orthodontic. Root canals fall under the major services tier, which also includes crowns, bridges, dentures, and oral surgery. To understand how deductibles, copays, and annual maximums affect your costs, see our guide on dental insurance deductibles, copays, and maximums.

Major services are typically covered at 50% to 80% of the plan's allowed amount. This means if your root canal costs $1,000 and your plan covers major services at 50%, the plan pays $500 and you pay $500. Some plans cover major services at 60% or even 80%, which reduces your out-of-pocket cost further. The specific coverage percentage is listed in your plan's schedule of benefits.

Before the plan pays its share, you will need to meet your annual deductible. Most dental plans have deductibles ranging from $50 to $150 per person. If you have already met your deductible for the year through other dental work, the plan's coverage kicks in immediately for the root canal. If you have not met the deductible, that amount is subtracted from the plan's payment first.

Here is an example. Suppose your molar root canal costs $1,200, your plan covers major services at 50%, and you have a $100 annual deductible that has not been met. The plan applies the $100 deductible first, leaving $1,100. At 50% coverage, the plan pays $550 and you pay $650 ($100 deductible plus $550 coinsurance). If the same plan covered major services at 80%, the plan would pay $880 and you would pay $320.

Annual Maximums and How They Affect Root Canal Coverage

Nearly all dental insurance plans have an annual maximum, which is the most the plan will pay for covered services in a calendar year. The typical annual maximum ranges from $1,000 to $2,500, with $1,500 being the most common. Once the plan has paid its maximum for the year, you are responsible for 100% of any remaining dental costs.

This is particularly important when a root canal and crown are needed on the same tooth. Suppose your root canal costs $1,200 and the crown costs $1,200. The combined total is $2,400. If your plan's annual maximum is $1,500, the plan will pay no more than $1,500 total for both procedures, even if the coverage percentage would otherwise entitle you to a higher payment. With a $1,500 maximum and 50% coverage on a $2,400 combined cost, the plan would pay its 50% share up to the $1,500 cap, leaving you with the remaining balance.

If you know you will need a root canal and crown, consider the timing. If it is late in the calendar year, you might be able to get the root canal in December and the crown in January, spreading the costs across two annual maximums. Talk to your dentist about whether this is a clinically appropriate option for your situation.

Waiting Periods for Root Canal Coverage

Most individual dental insurance plans impose waiting periods before they cover major services like root canals. The waiting period for major services is typically 6 to 12 months from the date of enrollment. During this time, you pay your premiums, but the plan will not cover root canals, crowns, or other major procedures.

Waiting periods exist because insurers want to prevent adverse selection, where people buy insurance only when they know they need an expensive procedure and cancel afterward. The waiting period ensures that members contribute premiums for a sustained period before accessing costly benefits.

Employer-sponsored group dental plans often have shorter waiting periods or no waiting periods at all for major services. If your employer offers dental insurance, this is often the fastest way to access root canal coverage. Some individual plans also advertise reduced or eliminated waiting periods, but these plans usually have higher premiums or lower annual maximums to offset the risk.

If you currently have a dental infection and need a root canal immediately, a waiting period means your insurance will not help right now. In this case, you will need to explore other options for managing the cost, which we cover later in this article.

The Crown After a Root Canal: Separate Coverage to Plan For

In most cases, a tooth that has undergone a root canal needs a crown to protect it from fracturing. After the pulp is removed, the tooth becomes more brittle and is at risk of breaking under normal chewing pressure. A crown covers the tooth and restores its strength and function. The exception is some front teeth, where a simple filling may be sufficient instead of a full crown.

Crowns are classified as major services on most dental plans, the same category as root canals. They are typically covered at 50% to 80%. A dental crown costs $800 to $1,500, with the price varying based on the material (porcelain, ceramic, metal, or porcelain-fused-to-metal), the location of the tooth, and your geographic area.

It is important to budget for both the root canal and the crown together. The combined out-of-pocket cost, even with insurance, can be significant. For a molar root canal at $1,200 and a crown at $1,200, your total cost with 50% coverage and a $1,500 annual maximum could be $1,200 or more out of pocket. Ask your dentist for a complete treatment plan with cost estimates for both procedures before you begin.

DHMO vs. PPO: How Plan Type Affects Root Canal Coverage

The two most common types of dental insurance plans are DHMO (Dental Health Maintenance Organization) and PPO (Preferred Provider Organization). Each handles root canal coverage differently, and understanding the differences can help you choose the right plan or get the most from your existing coverage.

DHMO Plans

DHMO plans charge a fixed copayment for each procedure. For a root canal, the copayment is typically $150 to $350 depending on the tooth. There is no deductible and no annual maximum, so you know exactly what you will pay upfront. The tradeoff is that you must choose a primary care dentist from the plan's network and get referrals for specialist care. If your dentist refers you to an endodontist, the copayment may be different from what the general dentist would charge.

DHMO plans tend to have lower monthly premiums and often have no waiting periods for major services. This makes them an attractive option if you need a root canal in the near future and want predictable costs. However, the network of dentists is smaller, and you have less flexibility in choosing providers.

PPO Plans

PPO plans cover root canals at a percentage of the allowed amount, typically 50% to 80% for major services. You pay a deductible first, then the plan pays its percentage up to the annual maximum. PPO plans offer a larger network of providers and allow you to see specialists without a referral. You can even see out-of-network providers, though your out-of-pocket costs will be higher.

PPO plans have higher monthly premiums than DHMO plans and usually impose waiting periods for major services. The annual maximum limits how much the plan will pay each year. For a single root canal and crown, the annual maximum may cover most of the plan's share. But if you need multiple procedures in the same year, you could exhaust the maximum quickly.

What to Do If You Need a Root Canal Without Insurance

If you do not have dental insurance or your plan's waiting period has not been satisfied, you still have options for getting the care you need. A dental infection will not resolve on its own and will get worse without treatment. For a complete guide to handling urgent dental situations, see our article on dental emergencies without insurance. Here are strategies to reduce the cost.

Dental Schools

Dental schools with endodontic programs perform root canals at significantly reduced rates, typically 30% to 50% less than private practice prices. The treatment is provided by dental students or endodontic residents under the direct supervision of experienced faculty. The quality of care is generally excellent, though appointments may take longer. There are more than 70 accredited dental schools in the United States, and most have clinics open to the public.

Community Health Centers

Federally qualified health centers (FQHCs) provide dental services on a sliding fee scale based on your income and family size. Many of these centers offer endodontic services, including root canals. You can find a community health center near you through the Health Resources and Services Administration website. These centers serve patients regardless of their ability to pay or insurance status.

Payment Plans and Financing

Many dentists and endodontists offer in-house payment plans that allow you to spread the cost over several months. These plans may be interest-free or carry a low interest rate. Third-party medical financing companies also offer dental payment plans with promotional zero-interest periods. Before agreeing to financing, make sure you understand the terms, including the interest rate that applies after any promotional period ends.

Dental Discount Plans

Dental discount plans are not insurance, but they provide negotiated reduced fees for dental procedures when you visit participating providers. For a monthly or annual membership fee, you can save 15% to 30% on root canals and other procedures. There are no waiting periods, no deductibles, and no annual maximums. A dental discount plan can be combined with a payment plan for additional savings.

HSA and FSA Accounts

If you have a health savings account (HSA) or flexible spending account (FSA) through your employer, root canals are a qualified medical expense. Using pre-tax dollars effectively reduces the cost by your marginal tax rate, which is typically 22% to 37% for most taxpayers. On a $1,200 root canal, this tax savings amounts to $264 to $444. Even if you do not have dental insurance, an HSA or FSA can meaningfully reduce what you pay.

When Extraction Is Cheaper Than a Root Canal

Some patients facing a costly root canal consider extraction as a less expensive alternative. A simple tooth extraction costs $150 to $350, and a surgical extraction costs $200 to $600. Compared to a root canal at $700 to $1,500 plus a crown at $800 to $1,500, extraction appears to be the budget-friendly choice.

However, the long-term costs tell a different story. After an extraction, the missing tooth should be replaced to prevent the surrounding teeth from shifting, to maintain your bite, and to prevent bone loss in the jaw. Replacement options include a dental implant ($3,000 to $5,000), a dental bridge ($1,500 to $5,000), or a partial denture ($500 to $2,500). When you add the replacement cost, extraction usually ends up costing more than saving the tooth with a root canal.

There are situations where extraction is the right choice. If the tooth is severely fractured below the gum line, if the root canals cannot be accessed or cleaned, or if there is not enough tooth structure to support a crown, extraction may be the only viable option. In cases where the tooth is a wisdom tooth or a tooth that will not significantly affect your bite or appearance, extraction without replacement may be appropriate.

Discuss the options with your dentist. Ask about the long-term prognosis of the tooth with a root canal versus the cost and implications of extraction and replacement. In most cases, preserving the natural tooth is both the healthier and more cost-effective choice.

How to Reduce Your Root Canal Costs With Insurance

If you have dental insurance, there are several strategies to minimize what you pay out of pocket for a root canal and crown.

• Use an in-network provider. In-network dentists and endodontists have agreed to accept the plan's allowed amount, which is lower than their standard fee. Using an in-network provider means lower costs for you and the plan covers a higher percentage.
• Time the procedures across calendar years. If you are approaching the end of the year, get the root canal in December and the crown in January to use two years of annual maximums. This can effectively double the insurance benefit available for the combined procedure.
• Verify your remaining annual maximum. Before scheduling the procedure, call your insurance company to confirm how much of your annual maximum remains. If you have already used a significant portion on other dental work, you may want to wait until the new plan year if your condition allows it.
• Get a pre-treatment estimate. Ask your dentist to submit a pre-treatment estimate, also called a predetermination, to your insurance company. The insurer will review the proposed treatment and provide a written estimate of what the plan will pay. This eliminates surprises and helps you plan for your share of the cost.
• Ask about alternative materials. For the crown, different materials have different costs. A metal crown may cost less than a porcelain crown, especially for a molar that is not visible when you smile. Your dentist can recommend the best material for your situation that balances durability, appearance, and cost.

Planning Ahead for Root Canal Costs

The best time to think about root canal coverage is before you need one. Regular dental checkups can catch problems early, sometimes before a root canal becomes necessary. A small cavity treated with a filling costs a fraction of what a root canal and crown cost. Preventive care, which most dental plans cover at 100%, is the most cost-effective way to avoid major dental expenses.

If you do not currently have dental insurance, enrolling in a plan now will start the clock on any waiting period for major services. Even if you do not need a root canal today, having coverage in place means the benefit will be available when you do need it. Consider the plan's coverage percentage for major services, the annual maximum, the waiting period, and the monthly premium when comparing options.

Whether you have insurance or not, understanding the costs and coverage options for root canals puts you in a better position to make informed decisions about your dental health. Root canals have a success rate of over 95% and can last a lifetime with proper care. The investment in saving your natural tooth pays off in both health and financial terms over the long run.