Dental Procedures
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ProcedureEstimate of Total Cost Number of Visits What You Will Pay Uninsured Discount: 0%
Dental Cleaning - Adult$121N/A$121
Dental Cleaning - Child$95N/A$95
Dental Exam - Comprehensive$105N/A$105
Dental Exam - Periodic, Established Patient$58N/A$58
Dental Filling - Silver (Amalgam): One Surface, Primary or Permanent$170N/A$170
Dental Filling - Silver (Amalgam): Three Surfaces, Primary or Permanent$362N/A$362
Dental Filling - Silver (Amalgam): Two Surfaces, Primary or Permanent$284N/A$284
Dental Filling - White (Resin): One Surface, Anterior$183N/A$183
Dental Filling - White (Resin): One Surface, Posterior$210N/A$210
Dental Filling - White (Resin): Three Surfaces, Posterior$362N/A$362
Dental Filling - White (Resin): Two Surfaces, Anterior$226N/A$226
Dental Filling - White (Resin): Two Surfaces, Posterior$284N/A$284
Flouride - Topical Varnish Application$47N/A$47
Fluoride - Topical Application$47N/A$47
Maintenance Therapy - Periodontal$158N/A$158
Oral Hygiene Instructions$44N/A$44
Plaque and Tartar Removal - Around Teeth and Gums, Per Quadrant$310N/A$310
Problem Focused Evaluation - Limited to a Specific Oral Health Problem or Complaint$96N/A$96
Root Canal - Bicuspid Tooth$1,134N/A$1,134
Root Canal - Molar$1,355N/A$1,355
Sealant - Placed on Tooth Surface to Prevent Decay$65N/A$65
Tooth Extraction - Elevation and/or Forceps Removal$215N/A$215
X-Ray - Additional Image of Tooth from Crown to Root from Inside Mouth$33N/A$33
X-Ray - Complete Intraoral Series$189N/A$189
X-Ray - Four Images, Bitewings$84N/A$84
X-Ray - Intraoral, Periapical Radiographic Image$39N/A$39
X-Ray - Two Images, Bitewings$84N/A$84
X-Ray - Whole Mouth from Outside Mouth$146N/A$146