In most states, $240 is a lot; I used to pay cash to my dentist in NY $173 per year for THREE cleanings and one exam (if you have healthy teeth you have no need for a bi-annual exam, that's just a dental scam, all you need is cleanings and one exam a year, I liked having a cleaning ever 4 months). Even my exam I just had last month was a near joke, he didn't even count off the teeth, just looked in for about 20 seconds.