Andover Pediatric Dentistry
Dental Procedures
| Procedure | Estimate of Total Cost | Uninsured Discount | What You Will Pay |
|---|---|---|---|
| Dental Cleaning - Adult | $210 | 0% | $210 |
| Dental Cleaning - Child | $200 | 0% | $200 |
| Dental Filling - White (Resin): One Surface, Posterior | $387 | 0% | $387 |
| Dental Filling - White (Resin): Two Surfaces, Posterior | $529 | 0% | $529 |
| Tooth Extraction - Elevation and/or Forceps Removal | $368 | 0% | $368 |
| X-Ray - Intraoral, Periapical Radiographic Image | $65 | 0% | $65 |
| X-Ray - Two Images, Bitewings | $105 | 0% | $105 |