Alan M. Gonick, DDS

122 Kenoza Avenue Haverhill, MA 01830
Dental Procedures
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ProcedureEstimate of Total Cost Uninsured Discount What You Will Pay Typical Patient Complexity
Dental Cleaning - Adult$1100%$110 Medium
Dental Cleaning - Child$880%$88 Medium
Dental Exam - Periodic, Established Patient$600%$60 Medium
Dental Filling - Silver (Amalgam): One Surface, Primary or Permanent$1850%$185 Medium
Dental Filling - Silver (Amalgam): Three Surfaces, Primary or Permanent$3180%$318 Medium
Dental Filling - Silver (Amalgam): Two Surfaces, Primary or Permanent$2350%$235 Medium
Dental Filling - White (Resin): One Surface, Anterior$2080%$208 Medium
Dental Filling - White (Resin): One Surface, Posterior$1960%$196 Medium
Dental Filling - White (Resin): Three Surfaces, Posterior$3700%$370 Medium
Dental Filling - White (Resin): Two Surfaces, Anterior$2690%$269 Medium
Dental Filling - White (Resin): Two Surfaces, Posterior$2420%$242 Medium
Flouride - Topical Varnish Application$580%$58 Medium
Maintenance Therapy - Periodontal$1930%$193 Medium
Plaque and Tartar Removal - Around Teeth and Gums, Per Quadrant$3150%$315 Medium
Problem Focused Evaluation - Limited to a Specific Oral Health Problem or Complaint$1010%$101 Medium
Root Canal - Anterior Tooth$1,0290%$1,029 Medium
Root Canal - Bicuspid Tooth$1,1500%$1,150 Medium
Root Canal - Molar$1,4180%$1,418 Medium
Sealant - Placed on Tooth Surface to Prevent Decay$700%$70 Medium
Tooth Extraction - Elevation and/or Forceps Removal$1910%$191 Medium
X-Ray - Additional Image of Tooth from Crown to Root from Inside Mouth$320%$32 Medium
X-Ray - Complete Intraoral Series$1970%$197 Medium
X-Ray - Four Images, Bitewings$1070%$107 Medium
X-Ray - Intraoral, Periapical Radiographic Image$380%$38 Medium
X-Ray - Two Images, Bitewings$740%$74 Medium
X-Ray - Whole Mouth from Outside Mouth$1870%$187 Medium