Beaudoin Dental
2 Streetilson Street Sanford, ME 04073
Dental Procedures
Preventive Care
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Adult Dental Cleaning | $101 | 0% | $101 | Medium |
| Child Dental Cleaning | $64 | 0% | $64 | Medium |
| Fluoride - Topical Application | $32 | 0% | $32 | Medium |
| Plaque and tartar removal from around teeth and gums-per quadrant | $249 | 0% | $249 | Medium |
| Sealant placed on the tooth surface to prevent decay | $58 | 0% | $58 | Medium |
| Topical fluoride varnish application | $45 | 0% | $45 | Medium |
Diagnostic Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Comprehensive Dental Exam | $119 | 0% | $119 | Medium |
| Periodic dental exam - established patient | $44 | 0% | $44 | Medium |
| Problem focused evaluation limited to a specific oral health problem or complaint | $87 | 0% | $87 | Medium |
| X-Ray Dental - Complete intraoral series | $139 | 0% | $139 | Medium |
| X-Ray Dental - Four images - bitewings | $68 | 0% | $68 | Medium |
| X-Ray Dental - Intraoral - periapical radiographic image | $40 | 0% | $40 | Medium |
| X-Ray Dental - Two images - bitewings | $55 | 0% | $55 | Medium |
| X-Ray Dental - Additional image of tooth from crown to root, from inside mouth | $27 | 0% | $27 | Medium |
| X-Ray Dental - Whole mouth, from outside mouth | $132 | 0% | $132 | Medium |
Dental Fillings
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Silver (Amalgam) Dental Filling - One surface, primary or permanent | $159 | 0% | $159 | Medium |
| Silver (Amalgam) Dental Filling - Two surfaces, primary or permanent | $257 | 0% | $257 | Medium |
| Silver (Amalgam) Dental Filling - Three surfaces, primary or permanent | $350 | 0% | $350 | Medium |
| White (Resin) Dental Filling - One surface, posterior | $212 | 0% | $212 | Medium |
| White (Resin) Dental Filling - Two surfaces, posterior | $254 | 0% | $254 | Medium |
| White (Resin) Dental Filling - One surface, anterior | $186 | 0% | $186 | Medium |
| White (Resin) Dental Filling - Three surfaces, posterior | $322 | 0% | $322 | Medium |
| White (Resin) Dental Filling - Two surfaces, anterior | $212 | 0% | $212 | Medium |
Orthodontic Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Orthodontic Treatment Visit (Periodic - as part of a contract) | $134 | 0% | $134 | Medium |
Other Dental Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Maintenance Therapy - Periodontal | $133 | 0% | $133 | Medium |
| Tooth Extraction (Elevation and/or forceps removal) | $275 | 0% | $275 | Medium |