$200 is pretty cheap - here on LI you can pay $500+ (especially if they have to extract). We are on the Banfield Veterinary Wellness plan so it is included (pay $340/year for everything - shots, exams, dental... and they have unlimited free office visits, discount on all medication). If you have a Banfield near you (located inside Petsmart stores) you should look into their services. Our vet is wonderful and we have saved $1,000's (I have 5 yorkies).