Angela J. Santavicca, DDS

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

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ProcedureEstimate of Total Cost Number of Visits What You Will Pay Uninsured Discount: 0%
Dental Cleaning - Adult$98N/A$98
Dental Cleaning - Child$78N/A$78
Dental Exam - Comprehensive$83N/A$83
Dental Exam - Periodic, Established Patient$47N/A$47
Dental Filling - Silver (Amalgam): One Surface, Primary or Permanent$166N/A$166
Dental Filling - Silver (Amalgam): Three Surfaces, Primary or Permanent$301N/A$301
Dental Filling - Silver (Amalgam): Two Surfaces, Primary or Permanent$231N/A$231
Dental Filling - White (Resin): One Surface, Anterior$148N/A$148
Dental Filling - White (Resin): One Surface, Posterior$166N/A$166
Dental Filling - White (Resin): Three Surfaces, Posterior$301N/A$301
Dental Filling - White (Resin): Two Surfaces, Anterior$181N/A$181
Dental Filling - White (Resin): Two Surfaces, Posterior$231N/A$231
Flouride - Topical Varnish Application$45N/A$45
Maintenance Therapy - Periodontal$144N/A$144
Oral Hygiene Instructions$43N/A$43
Plaque and Tartar Removal - Around Teeth and Gums, Per Quadrant$254N/A$254
Problem Focused Evaluation - Limited to a Specific Oral Health Problem or Complaint$80N/A$80
Sealant - Placed on Tooth Surface to Prevent Decay$57N/A$57
Tooth Extraction - Elevation and/or Forceps Removal$172N/A$172
X-Ray - Additional Image of Tooth from Crown to Root from Inside Mouth$25N/A$25
X-Ray - Complete Intraoral Series$140N/A$140
X-Ray - Four Images, Bitewings$65N/A$65
X-Ray - Intraoral, Periapical Radiographic Image$34N/A$34
X-Ray - Two Images, Bitewings$47N/A$47
X-Ray - Whole Mouth from Outside Mouth$144N/A$144