Amidon Family Dentistry
22 Prospect Street Nashua, NH 03060
Dental Procedures
Preventive Care
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Adult Dental Cleaning | $104 | 0% | $104 | Medium |
| Child Dental Cleaning | $81 | 0% | $81 | Medium |
| Fluoride - Topical Application | $40 | 0% | $40 | Medium |
| Sealant placed on the tooth surface to prevent decay | $57 | 0% | $57 | Medium |
| Topical fluoride varnish application | $40 | 0% | $40 | Medium |
Diagnostic Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Comprehensive Dental Exam | $85 | 0% | $85 | Medium |
| Periodic dental exam - established patient | $48 | 0% | $48 | Medium |
| Problem focused evaluation limited to a specific oral health problem or complaint | $97 | 0% | $97 | Medium |
| X-Ray Dental - Complete intraoral series | $155 | 0% | $155 | Medium |
| X-Ray Dental - Four images - bitewings | $68 | 0% | $68 | Medium |
| X-Ray Dental - Intraoral - periapical radiographic image | $47 | 0% | $47 | Medium |
| X-Ray Dental - Two images - bitewings | $50 | 0% | $50 | Medium |
| X-Ray Dental - Additional image of tooth from crown to root, from inside mouth | $34 | 0% | $34 | Medium |
| X-Ray Dental - Whole mouth, from outside mouth | $117 | 0% | $117 | 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 | $231 | 0% | $231 | Medium |
| Silver (Amalgam) Dental Filling - Two surfaces, primary or permanent | $273 | 0% | $273 | Medium |
| Silver (Amalgam) Dental Filling - Three surfaces, primary or permanent | $278 | 0% | $278 | Medium |
| White (Resin) Dental Filling - One surface, posterior | $231 | 0% | $231 | Medium |
| White (Resin) Dental Filling - Two surfaces, posterior | $273 | 0% | $273 | Medium |
| White (Resin) Dental Filling - One surface, anterior | $185 | 0% | $185 | Medium |
| White (Resin) Dental Filling - Three surfaces, posterior | $334 | 0% | $334 | Medium |
| White (Resin) Dental Filling - Two surfaces, anterior | $239 | 0% | $239 | Medium |
Other Dental Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Maintenance Therapy - Periodontal | $142 | 0% | $142 | Medium |
| Tooth Extraction (Elevation and/or forceps removal) | $192 | 0% | $192 | Medium |