Andrew Zale, DDS
Dental Procedures
| Procedure | Estimate of Total Cost | Uninsured Discount | What You Will Pay |
|---|---|---|---|
| Dental Cleaning - Adult | $116 | 0% | $116 |
| Dental Exam - Periodic, Established Patient | $63 | 0% | $63 |
| Dental Filling - Silver (Amalgam): One Surface, Primary or Permanent | $200 | 0% | $200 |
| Dental Filling - Silver (Amalgam): Two Surfaces, Primary or Permanent | $221 | 0% | $221 |
| Dental Filling - White (Resin): One Surface, Posterior | $399 | 0% | $399 |
| Dental Filling - White (Resin): Two Surfaces, Posterior | $504 | 0% | $504 |
| X-Ray - Additional Image of Tooth from Crown to Root from Inside Mouth | $53 | 0% | $53 |
| X-Ray - Complete Intraoral Series | $168 | 0% | $168 |
| X-Ray - Four Images, Bitewings | $79 | 0% | $79 |
| X-Ray - Intraoral, Periapical Radiographic Image | $74 | 0% | $74 |
| X-Ray - Two Images, Bitewings | $116 | 0% | $116 |