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Dental Plans / PPO BuyUp Dental Plan . Plans 100, 200, 300 Supplemental Fee Schedule - Provider Reimbursement Schedule Supplementals are paid for eligible covered services in addition to the member's copayment Payment guidelines must be followed Basic Services See copay schedule See copay schedule Endodontic $0 - $525 $0 - $170 Periodontal $0 - $60 $0 - $60.