Dental Procedures
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ProcedureEstimate of Total Cost Number of Visits What You Will Pay Uninsured Discount: 0%
Dental Cleaning - Adult$117N/A$117
Dental Cleaning - Child$100N/A$100
Dental Exam - Comprehensive$116N/A$116
Dental Exam - Periodic, Established Patient$63N/A$63
Dental Filling - Silver (Amalgam): One Surface, Primary or Permanent$214N/A$214
Dental Filling - Silver (Amalgam): Three Surfaces, Primary or Permanent$374N/A$374
Dental Filling - Silver (Amalgam): Two Surfaces, Primary or Permanent$289N/A$289
Dental Filling - White (Resin): One Surface, Anterior$194N/A$194
Dental Filling - White (Resin): One Surface, Posterior$214N/A$214
Dental Filling - White (Resin): Three Surfaces, Posterior$374N/A$374
Dental Filling - White (Resin): Two Surfaces, Anterior$230N/A$230
Dental Filling - White (Resin): Two Surfaces, Posterior$289N/A$289
Flouride - Topical Varnish Application$50N/A$50
Maintenance Therapy - Periodontal$174N/A$174
Plaque and Tartar Removal - Around Teeth and Gums, Per Quadrant$302N/A$302
Problem Focused Evaluation - Limited to a Specific Oral Health Problem or Complaint$110N/A$110
Root Canal - Molar$1,703N/A$1,703
Sealant - Placed on Tooth Surface to Prevent Decay$61N/A$61
Tooth Extraction - Elevation and/or Forceps Removal$289N/A$289
X-Ray - Additional Image of Tooth from Crown to Root from Inside Mouth$35N/A$35
X-Ray - Complete Intraoral Series$233N/A$233
X-Ray - Four Images, Bitewings$88N/A$88
X-Ray - Intraoral, Periapical Radiographic Image$38N/A$38
X-Ray - Two Images, Bitewings$61N/A$61
X-Ray - Whole Mouth from Outside Mouth$145N/A$145