Dental Procedures
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ProcedureEstimate of Total Cost Number of Visits What You Will Pay Uninsured Discount: 0%
Dental Cleaning - Adult$123N/A$123
Dental Cleaning - Child$88N/A$88
Dental Exam - Comprehensive$106N/A$106
Dental Exam - Periodic, Established Patient$60N/A$60
Dental Filling - Silver (Amalgam): One Surface, Primary or Permanent$219N/A$219
Dental Filling - Silver (Amalgam): Three Surfaces, Primary or Permanent$353N/A$353
Dental Filling - Silver (Amalgam): Two Surfaces, Primary or Permanent$287N/A$287
Dental Filling - White (Resin): One Surface, Anterior$192N/A$192
Dental Filling - White (Resin): One Surface, Posterior$219N/A$219
Dental Filling - White (Resin): Three Surfaces, Posterior$361N/A$361
Dental Filling - White (Resin): Two Surfaces, Anterior$248N/A$248
Dental Filling - White (Resin): Two Surfaces, Posterior$295N/A$295
Flouride - Topical Varnish Application$42N/A$42
Fluoride - Topical Application$45N/A$45
Maintenance Therapy - Periodontal$187N/A$187
Plaque and Tartar Removal - Around Teeth and Gums, Per Quadrant$313N/A$313
Problem Focused Evaluation - Limited to a Specific Oral Health Problem or Complaint$109N/A$109
Root Canal - Anterior Tooth$1,066N/A$1,066
Root Canal - Bicuspid Tooth$1,305N/A$1,305
Root Canal - Molar$1,572N/A$1,572
Sealant - Placed on Tooth Surface to Prevent Decay$69N/A$69
Tooth Extraction - Elevation and/or Forceps Removal$233N/A$233
X-Ray - Additional Image of Tooth from Crown to Root from Inside Mouth$35N/A$35
X-Ray - Complete Intraoral Series$235N/A$235
X-Ray - Four Images, Bitewings$84N/A$84
X-Ray - Intraoral, Periapical Radiographic Image$45N/A$45
X-Ray - Two Images, Bitewings$62N/A$62
X-Ray - Whole Mouth from Outside Mouth$161N/A$161