Beacon Family Medicine

130 Country Road, Suite G Ipswich, MA 01938
Dental Procedures
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Preventive Care

ProcedureEstimate of Total Cost Uninsured Discount What you Will Pay Typical Patient Complexity
Adult Dental Cleaning$1260%$126 Medium
Child Dental Cleaning$920%$92 Medium
Fluoride - Topical Application$440%$44 Medium
Sealant placed on the tooth surface to prevent decay$750%$75 Medium
Topical fluoride varnish application$280%$28 Medium

Diagnostic Services

ProcedureEstimate of Total Cost Uninsured Discount What you Will Pay Typical Patient Complexity
Comprehensive Dental Exam$1260%$126 Medium
Periodic dental exam - established patient$700%$70 Medium
X-Ray Dental - Complete intraoral series$1750%$175 Medium
X-Ray Dental - Four images - bitewings$900%$90 Medium
X-Ray Dental - Intraoral - periapical radiographic image$390%$39 Medium
X-Ray Dental - Additional image of tooth from crown to root, from inside mouth$340%$34 Medium

Dental Fillings

ProcedureEstimate of Total Cost Uninsured Discount What you Will Pay Typical Patient Complexity
Silver (Amalgam) Dental Filling - Two surfaces, primary or permanent$3300%$330 Medium
White (Resin) Dental Filling - One surface, posterior$2560%$256 Medium
White (Resin) Dental Filling - Two surfaces, posterior$3300%$330 Medium
White (Resin) Dental Filling - Three surfaces, posterior$4100%$410 Medium

Other Dental Services

ProcedureEstimate of Total Cost Uninsured Discount What you Will Pay Typical Patient Complexity
Maintenance Therapy - Periodontal$1820%$182 Medium
Tooth Extraction (Elevation and/or forceps removal)$2660%$266 Medium