Andover Family Dental
Dental Procedures
| Procedure | Estimate of Total Cost | Number of Visits | What You Will Pay Uninsured Discount: 0% |
|---|---|---|---|
| Dental Cleaning - Adult | $133 | N/A | $133 |
| Dental Exam - Comprehensive | $146 | N/A | $146 |
| Dental Exam - Periodic, Established Patient | $76 | N/A | $76 |
| Dental Filling - Silver (Amalgam): One Surface, Primary or Permanent | $275 | N/A | $275 |
| Dental Filling - White (Resin): Three Surfaces, Posterior | $416 | N/A | $416 |
| Dental Filling - White (Resin): Two Surfaces, Anterior | $338 | N/A | $338 |
| Dental Filling - White (Resin): Two Surfaces, Posterior | $332 | N/A | $332 |
| X-Ray - Additional Image of Tooth from Crown to Root from Inside Mouth | $29 | N/A | $29 |
| X-Ray - Complete Intraoral Series | $197 | N/A | $197 |
| X-Ray - Four Images, Bitewings | $97 | N/A | $97 |
| X-Ray - Intraoral, Periapical Radiographic Image | $37 | N/A | $37 |