Alpha Dental of New England
39 Simon Street, Suite 8 Nashua, NH 03060
Dental Procedures
Preventive Care
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Adult Dental Cleaning | $102 | 0% | $102 | Medium |
| Child Dental Cleaning | $78 | 0% | $78 | Medium |
| Fluoride - Topical Application | $47 | 0% | $47 | Medium |
| Plaque and tartar removal from around teeth and gums-per quadrant | $281 | 0% | $281 | Medium |
Diagnostic Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Comprehensive Dental Exam | $104 | 0% | $104 | Medium |
| Periodic dental exam - established patient | $57 | 0% | $57 | Medium |
| Problem focused evaluation limited to a specific oral health problem or complaint | $85 | 0% | $85 | Medium |
| X-Ray Dental - Complete intraoral series | $144 | 0% | $144 | Medium |
| X-Ray Dental - Four images - bitewings | $71 | 0% | $71 | Medium |
| X-Ray Dental - Intraoral - periapical radiographic image | $33 | 0% | $33 | Medium |
| X-Ray Dental - Two images - bitewings | $63 | 0% | $63 | Medium |
| X-Ray Dental - Additional image of tooth from crown to root, from inside mouth | $29 | 0% | $29 | Medium |
Dental Fillings
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Silver (Amalgam) Dental Filling - One surface, primary or permanent | $201 | 0% | $201 | Medium |
| Silver (Amalgam) Dental Filling - Two surfaces, primary or permanent | $258 | 0% | $258 | Medium |
| Silver (Amalgam) Dental Filling - Three surfaces, primary or permanent | $327 | 0% | $327 | Medium |
| White (Resin) Dental Filling - One surface, posterior | $201 | 0% | $201 | Medium |
| White (Resin) Dental Filling - Two surfaces, posterior | $258 | 0% | $258 | Medium |
| White (Resin) Dental Filling - One surface, anterior | $179 | 0% | $179 | Medium |
| White (Resin) Dental Filling - Three surfaces, posterior | $328 | 0% | $328 | Medium |
| White (Resin) Dental Filling - Two surfaces, anterior | $225 | 0% | $225 | Medium |
Other Dental Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Maintenance Therapy - Periodontal | $154 | 0% | $154 | Medium |
| Tooth Extraction (Elevation and/or forceps removal) | $260 | 0% | $260 | Medium |