Dental plans may use the terms "Usual, Customary and Reasonable" (UCR) to determine the portion of the dental treatment fee they are willing to pay for a particular procedure. As noted earlier the terms Usual, Customary and Reasonable are not interchangeable and "UCR" is a misleading acronym. Usual fees are determined by the dentist. An insurance company creates its own "Customary" fee schedule. There is no universally accepted method for determining the Customary fee schedule, which may vary a great deal among plans – even when those plans operate in the same area. The fee the insurance company determines to be "Customary" may be lower than area dentists' Usual fee for the same service.
The benefit paid will generally be based on a percentage of the insurance company's Customary fee schedule. Patients often do not know what their out-of-pocket costs will be because third-party payers generally do not release their Customary fee schedule maximums to the public.