Angela J. Santavicca, DDS

367 NH Route 121 Lebanon, NH 03766
Dental Procedures
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My Health Insurance:

  • I do not have dental insurance
ProcedureEstimate of Total Cost Uninsured Discount What You Will Pay Typical Patient Complexity
Dental Cleaning - Adult$980%$98 Medium
Dental Cleaning - Child$780%$78 Medium
Dental Exam - Comprehensive$830%$83 Medium
Dental Exam - Periodic, Established Patient$460%$46 Medium
Dental Filling - Silver (Amalgam): One Surface, Primary or Permanent$1660%$166 Medium
Dental Filling - Silver (Amalgam): Three Surfaces, Primary or Permanent$2750%$275 Medium
Dental Filling - Silver (Amalgam): Two Surfaces, Primary or Permanent$2210%$221 Medium
Dental Filling - White (Resin): One Surface, Anterior$1450%$145 Medium
Dental Filling - White (Resin): One Surface, Posterior$1660%$166 Medium
Dental Filling - White (Resin): Three Surfaces, Posterior$2750%$275 Medium
Dental Filling - White (Resin): Two Surfaces, Anterior$1810%$181 Medium
Dental Filling - White (Resin): Two Surfaces, Posterior$2210%$221 Medium
Flouride - Topical Varnish Application$450%$45 Medium
Maintenance Therapy - Periodontal$1440%$144 Medium
Plaque and Tartar Removal - Around Teeth and Gums, Per Quadrant$2540%$254 Medium
Problem Focused Evaluation - Limited to a Specific Oral Health Problem or Complaint$800%$80 Medium
Sealant - Placed on Tooth Surface to Prevent Decay$570%$57 Medium
Tooth Extraction - Elevation and/or Forceps Removal$1720%$172 Medium
X-Ray - Additional Image of Tooth from Crown to Root from Inside Mouth$240%$24 Medium
X-Ray - Complete Intraoral Series$1400%$140 Medium
X-Ray - Four Images, Bitewings$650%$65 Medium
X-Ray - Intraoral, Periapical Radiographic Image$300%$30 Medium
X-Ray - Two Images, Bitewings$470%$47 Medium
X-Ray - Whole Mouth from Outside Mouth$1260%$126 Medium