Beacon Family Medicine
Dental Procedures
| Procedure | Estimate of Total Cost | Number of Visits | What You Will Pay Uninsured Discount: 0% |
|---|---|---|---|
| Dental Cleaning - Adult | $126 | N/A | $126 |
| Dental Cleaning - Child | $92 | N/A | $92 |
| Dental Exam - Comprehensive | $124 | N/A | $124 |
| Dental Exam - Periodic, Established Patient | $70 | N/A | $70 |
| Dental Filling - White (Resin): Two Surfaces, Posterior | $330 | N/A | $330 |
| Fluoride - Topical Application | $44 | N/A | $44 |
| Maintenance Therapy - Periodontal | $182 | N/A | $182 |
| Plaque and Tartar Removal - Around Teeth and Gums, Per Quadrant | $334 | N/A | $334 |
| Problem Focused Evaluation - Limited to a Specific Oral Health Problem or Complaint | $104 | N/A | $104 |
| X-Ray - Additional Image of Tooth from Crown to Root from Inside Mouth | $34 | N/A | $34 |
| X-Ray - Complete Intraoral Series | $190 | N/A | $190 |
| X-Ray - Four Images, Bitewings | $90 | N/A | $90 |
| X-Ray - Intraoral, Periapical Radiographic Image | $39 | N/A | $39 |
| X-Ray - Two Images, Bitewings | $63 | N/A | $63 |