Andover Smiles
Dental Procedures
| Procedure | Estimate of Total Cost | Uninsured Discount | What You Will Pay |
|---|---|---|---|
| Dental Cleaning - Adult | $156 | 0% | $156 |
| Dental Exam - Periodic, Established Patient | $98 | 0% | $98 |
| Dental Filling - White (Resin): One Surface, Posterior | $310 | 0% | $310 |
| Dental Filling - White (Resin): Two Surfaces, Posterior | $499 | 0% | $499 |
| Problem Focused Evaluation - Limited to a Specific Oral Health Problem or Complaint | $107 | 0% | $107 |
| X-Ray - Complete Intraoral Series | $331 | 0% | $331 |
| X-Ray - Four Images, Bitewings | $137 | 0% | $137 |
| X-Ray - Intraoral, Periapical Radiographic Image | $60 | 0% | $60 |