Many people receive notification from their insurance company that dental fees are "above usual and customary". An insurance company sometimes determines their reimbursement level by surveying a geographical area, calculating the average fee, then determines that 80% of the average fee to be customary. Included in this survey are discount dental clinics and managed care facilities, which have severely reduced dental fees that bring down the average. Each insurance company has their own formula to calculate different UCR’s. Most doctors in private practice will have fees that insurance companies define as "higher than usual and customary."