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Thanks for useful info. Especially for advice to call the insurance.

The story did not end. I called insurance today and they confirmed that the provider is in network, and that they should pay me...

Thanks Ebaines!
The explanation of benefits lists these $500 in "provider discount/disallow" column and gives the following comment:
9A6: The charge exceeds the Delta amount allowed

About the...

Hello experts!
Here is briefly what happened. My wife had dental surgery in June. We paid a small portion (~$50) of the total ($900) at the desk and the rest was supposed to be covered by insurance....