Bay Breeze Dentistry

14 Manchester Square, Suite 215 Portsmouth, NH 03801
Dental Procedures
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ProcedureEstimate of Total Cost Uninsured Discount What You Will Pay Typical Patient Complexity
Dental Cleaning - Adult$1380%$138 Medium
Dental Cleaning - Child$1200%$120 Medium
Dental Exam - Comprehensive$1220%$122 Medium
Dental Exam - Periodic, Established Patient$750%$75 Medium
Dental Filling - Silver (Amalgam): One Surface, Primary or Permanent$2230%$223 Medium
Dental Filling - Silver (Amalgam): Three Surfaces, Primary or Permanent$3540%$354 Medium
Dental Filling - Silver (Amalgam): Two Surfaces, Primary or Permanent$2770%$277 Medium
Dental Filling - White (Resin): One Surface, Anterior$2120%$212 Medium
Dental Filling - White (Resin): One Surface, Posterior$2330%$233 Medium
Dental Filling - White (Resin): Three Surfaces, Posterior$3910%$391 Medium
Dental Filling - White (Resin): Two Surfaces, Anterior$2710%$271 Medium
Dental Filling - White (Resin): Two Surfaces, Posterior$2960%$296 Medium
Flouride - Topical Varnish Application$620%$62 Medium
Maintenance Therapy - Periodontal$1970%$197 Medium
Plaque and Tartar Removal - Around Teeth and Gums, Per Quadrant$3950%$395 Medium
Problem Focused Evaluation - Limited to a Specific Oral Health Problem or Complaint$1110%$111 Medium
Sealant - Placed on Tooth Surface to Prevent Decay$760%$76 Medium
Tooth Extraction - Elevation and/or Forceps Removal$2690%$269 Medium
X-Ray - Additional Image of Tooth from Crown to Root from Inside Mouth$330%$33 Medium
X-Ray - Complete Intraoral Series$1880%$188 Medium
X-Ray - Four Images, Bitewings$950%$95 Medium
X-Ray - Intraoral, Periapical Radiographic Image$430%$43 Medium
X-Ray - Two Images, Bitewings$760%$76 Medium