Cost & Insurance

What TMJ Diagnosis and Treatment Actually Cost

Name: SoCal TMJ and Headache
Address: Los Angeles, CA, 90006, US
Telephone: +13232389134
Price range: $650

Cost is the last question patients ask and the first they worry about. This page answers it directly: what the first visit costs, what insurance does and does not cover, how the superbill process works, and what happens after a diagnosis is made. No hidden numbers — and no “come in and we'll discuss pricing.”

Diagnostic Consultation

The First Visit

The first visit is a diagnostic consultation, priced at $650. It is a 60 to 90 minute appointment built to produce a diagnosis, not a sales conversation. You are seen by Dr. Sang H. Chung, DMD — board-qualified in orofacial pain (ABOP), USC-certified in Orofacial Pain and Oral Medicine — not a general dentist adding TMJ to a cosmetic practice. The fee covers the entire evaluation: the complete clinical workup that determines what is actually causing your pain, and therefore what treatment is actually indicated.

Most patients arriving at a TMJ specialist have already spent money on treatments that failed because no one established what subtype they had. The consultation fee buys the step that was skipped: a structured differential diagnosis of the masticatory system.

What the Consultation Includes

Comprehensive History ReviewA structured review of your pain history, prior treatments, imaging, and medical records — often the single most diagnostic hour of the visit. Patterns of onset, referral, and treatment response narrow the differential before any testing begins.
Cranial Nerve ExaminationA systematic neurological screen of the trigeminal, facial, and related cranial nerves. This distinguishes musculoskeletal TMJ pain from neuropathic and neurovascular mimics — the distinction that guides treatment.

Jaw Range-of-Motion TestingMeasured assessment of opening, lateral excursions, protrusion, and joint loading — with palpation of the masticatory muscles and the joint itself. Findings here separate muscle-dominant from joint-dominant pathology.
Intraoral AssessmentExamination of the dentition, occlusion, and oral soft tissues, including screening for parafunctional wear patterns and mucosal changes. This completes the picture of how the system is being loaded and how it is responding.

A 3-D CBCT jaw scan is included in the consultation fee. If other imaging, such as an MRI, is needed, the reason and the cost are explained before it is ordered — never after. A non-refundable reservation fee holds your appointment and is applied to the consultation fee.

Insurance & Reimbursement

What Insurance Does — and Does Not — Cover

This practice operates as an out-of-network specialist, and coverage decisions never dictate the diagnosis. Our team prepares itemized superbills with the CDT procedure codes and ICD-10 diagnosis codes your plan requires, and helps you submit the out-of-network claim to your medical insurance for possible reimbursement.

One distinction matters more than any other: orofacial pain sits at the boundary between medical and dental insurance, and plans routinely shift TMJ claims between the two. Temporomandibular disorders are frequently covered — when they are covered — under medical benefits rather than dental benefits, because the diagnosis codes are medical. Knowing which benefit to file against is often the difference between a paid claim and a denied one.

No referral is needed to book, and no insurance authorization is required. You pay the practice directly, and our team helps you file the claim with your medical insurance. Your plan, not this office, decides the points below.

What This Office Provides

Superbills with CDT procedure codes and ICD-10 diagnosis codes, plus help submitting the claim to your medical insurance
Itemized receipts and diagnostic documentation required by HSA and FSA account administrators
Fee disclosure in writing before any treatment begins

What Your Plan Determines

Whether out-of-network services are reimbursed, and at what percentage of the fee
Whether the claim routes to medical or dental benefits — or is denied as a carve-out
Your deductible status and any visit limits at the time of submission
Final adjudication of any claim you submit with our documentation

Fee questions answered before you book — that is the point of a written estimate. The first visit is a flat $650, and a reservation fee applied to it holds your time.

Book Your Consultation Call

Written Estimates

After the Diagnosis: Treatment Fees

The consultation fee is the only number we can quote before examining you — because it is the only fee that is the same for every patient. What follows the diagnosis depends on what the diagnosis is. Appliance therapy, injection treatment, physical medicine referral, pharmacologic management: each carries its own fee range, and each is stated in writing before treatment begins.

The commitment is structural, not a courtesy: no treatment starts before you have seen the full number first. The written fee estimate itemizes what each phase costs, so the decision to proceed is made with the complete figure — not discovered one appointment at a time.

This is also why the consultation comes first. A practice that quotes treatment prices over the phone, before any examination, is pricing a guess. Once the subtype is known, the downstream fees are knowable — and we put them in writing.

Price Transparency

Why We Publish Our Prices

Most TMJ practices will not tell you what anything costs until you are in the chair. Ask about fees and the answer is some version of “it depends” — which is true in the narrow sense and used in the dishonest one. It depends because the diagnosis determines the treatment. But the consultation fee, the superbill policy, and the written-estimate process do not depend on anything. They are the same for everyone, and they are printed above.

A practice confident in its diagnosis has nothing to hide. The diagnostic-primacy model — determine the subtype first, treat the subtype second — only works if patients can verify the economics before they commit. Withholding pricing until the patient is already invested is a sales tactic, and it is the opposite of how medicine should be practiced.

Patients deserve numbers. You now have ours. What remains uncertain — the exact treatment plan and its final cost — becomes certain the same way everything else here does: through the diagnosis.

Frequently Asked Questions

TMJ Costs: Common Questions

Does insurance cover TMJ treatment?

Coverage depends on your plan and on the diagnosis. This practice is an out-of-network specialist. We prepare a superbill with the CDT and ICD-10 codes and help you submit the claim to your medical insurance for possible reimbursement, and orofacial pain services are more often reimbursed under medical benefits than dental benefits. No referral is needed and no authorization is required to book. You pay the practice directly, and our team handles the claim paperwork with you.

How much does TMJ treatment cost without insurance?

The diagnostic consultation is $650 — a 60 to 90 minute visit that includes a full history review, cranial nerve examination, jaw range-of-motion testing, and intraoral assessment. A 3-D CBCT jaw scan is included at no extra charge. A non-refundable reservation fee holds your appointment and is applied to the $650. After the diagnosis, every downstream treatment fee is stated in a written estimate before treatment begins, so you see the full number before anything starts.

Are payment plans available?

Every fee is confirmed in writing before treatment begins, and the coordinator can discuss the structure of larger treatment plans with you directly. The diagnostic consultation is a single flat fee, so there is nothing to finance at that stage. If a multi-visit treatment plan follows the diagnosis, the full cost is presented in a written estimate first, and payment timing is discussed openly with the coordinator before you commit to anything.

Is imaging extra?

A 3-D CBCT jaw scan is included in the consultation fee at no extra charge. If other imaging, such as an MRI, is needed, the clinical reason and the cost are explained before it is ordered. Imaging is never ordered without the justification being discussed with you first.

Can I use HSA or FSA funds?

Yes. Orofacial pain diagnosis and treatment are eligible expenses under Health Savings Accounts and Flexible Spending Accounts. Itemized receipts and the diagnostic documentation your account administrator requires are provided, and the superbill we prepare for insurance submission contains the codes most administrators ask for.