3d Dental
Dental Procedures
| Procedure | Estimate of Total Cost | Uninsured Discount | What You Will Pay |
|---|---|---|---|
| Dental Cleaning - Adult | $143 | 0% | $143 |
| Dental Cleaning - Child | $109 | 0% | $109 |
| Dental Exam - Comprehensive | $127 | 0% | $127 |
| Dental Exam - Periodic, Established Patient | $71 | 0% | $71 |
| Dental Filling - Silver (Amalgam): One Surface, Primary or Permanent | $245 | 0% | $245 |
| Dental Filling - White (Resin): Two Surfaces, Posterior | $314 | 0% | $314 |
| Flouride - Topical Varnish Application | $55 | 0% | $55 |
| Fluoride - Topical Application | $47 | 0% | $47 |
| Maintenance Therapy - Periodontal | $187 | 0% | $187 |
| Plaque and Tartar Removal - Around Teeth and Gums, Per Quadrant | $315 | 0% | $315 |
| Root Canal - Bicuspid Tooth | $1,325 | 0% | $1,325 |
| Root Canal - Molar | $1,571 | 0% | $1,571 |
| X-Ray - Complete Intraoral Series | $201 | 0% | $201 |
| X-Ray - Four Images, Bitewings | $92 | 0% | $92 |
| X-Ray - Intraoral, Periapical Radiographic Image | $38 | 0% | $38 |