Beacon Family Medicine
Dental Procedures
| Procedure | Estimate of Total Cost | Uninsured Discount | What You Will Pay |
|---|---|---|---|
| Dental Cleaning - Adult | $126 | 0% | $126 |
| Dental Cleaning - Child | $92 | 0% | $92 |
| Dental Exam - Comprehensive | $125 | 0% | $125 |
| Dental Exam - Periodic, Established Patient | $70 | 0% | $70 |
| Dental Filling - White (Resin): One Surface, Posterior | $256 | 0% | $256 |
| Dental Filling - White (Resin): Two Surfaces, Posterior | $330 | 0% | $330 |
| Fluoride - Topical Application | $44 | 0% | $44 |
| Plaque and Tartar Removal - Around Teeth and Gums, Per Quadrant | $334 | 0% | $334 |
| Problem Focused Evaluation - Limited to a Specific Oral Health Problem or Complaint | $109 | 0% | $109 |
| Root Canal - Molar | $1,787 | 0% | $1,787 |
| X-Ray - Additional Image of Tooth from Crown to Root from Inside Mouth | $34 | 0% | $34 |
| X-Ray - Complete Intraoral Series | $175 | 0% | $175 |
| X-Ray - Four Images, Bitewings | $90 | 0% | $90 |
| X-Ray - Intraoral, Periapical Radiographic Image | $39 | 0% | $39 |
| X-Ray - Two Images, Bitewings | $63 | 0% | $63 |