Belknap Dental Associates

40 Chestnut Street, Suite 2 Dover, NH 03820
Dental Procedures
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ProcedureEstimate of Total Cost Uninsured Discount What You Will Pay
Dental Cleaning - Adult$1070%$107
Dental Cleaning - Child$860%$86
Dental Exam - Comprehensive$930%$93
Dental Exam - Periodic, Established Patient$510%$51
Dental Filling - Silver (Amalgam): One Surface, Primary or Permanent$2050%$205
Dental Filling - Silver (Amalgam): Three Surfaces, Primary or Permanent$3430%$343
Dental Filling - Silver (Amalgam): Two Surfaces, Primary or Permanent$2690%$269
Dental Filling - White (Resin): One Surface, Anterior$1750%$175
Dental Filling - White (Resin): One Surface, Posterior$2050%$205
Dental Filling - White (Resin): Three Surfaces, Posterior$3430%$343
Dental Filling - White (Resin): Two Surfaces, Anterior$2240%$224
Dental Filling - White (Resin): Two Surfaces, Posterior$2690%$269
Flouride - Topical Varnish Application$410%$41
Fluoride - Topical Application$410%$41
Maintenance Therapy - Periodontal$1600%$160
Plaque and Tartar Removal - Around Teeth and Gums, Per Quadrant$4430%$443
Problem Focused Evaluation - Limited to a Specific Oral Health Problem or Complaint$890%$89
Root Canal - Anterior Tooth$9500%$950
Root Canal - Bicuspid Tooth$1,1020%$1,102
Sealant - Placed on Tooth Surface to Prevent Decay$620%$62
Tooth Extraction - Elevation and/or Forceps Removal$2180%$218
X-Ray - Additional Image of Tooth from Crown to Root from Inside Mouth$300%$30
X-Ray - Complete Intraoral Series$1650%$165
X-Ray - Four Images, Bitewings$770%$77
X-Ray - Intraoral, Periapical Radiographic Image$380%$38
X-Ray - Two Images, Bitewings$560%$56
X-Ray - Whole Mouth from Outside Mouth$1390%$139