Brian J. Wicenski, DMD, Mary E. Wicenski, DMD

27 Newport Road New London, NH 03257
Dental Procedures
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ProcedureEstimate of Total Cost Uninsured Discount What You Will Pay Typical Patient Complexity
Dental Cleaning - Adult$1090%$109 Medium
Dental Cleaning - Child$810%$81 Medium
Dental Exam - Comprehensive$920%$92 Medium
Dental Exam - Periodic, Established Patient$540%$54 Medium
Dental Filling - Silver (Amalgam): One Surface, Primary or Permanent$2150%$215 Medium
Dental Filling - Silver (Amalgam): Three Surfaces, Primary or Permanent$3540%$354 Medium
Dental Filling - Silver (Amalgam): Two Surfaces, Primary or Permanent$2400%$240 Medium
Dental Filling - White (Resin): One Surface, Anterior$2060%$206 Medium
Dental Filling - White (Resin): One Surface, Posterior$2150%$215 Medium
Dental Filling - White (Resin): Three Surfaces, Posterior$3540%$354 Medium
Dental Filling - White (Resin): Two Surfaces, Anterior$2640%$264 Medium
Dental Filling - White (Resin): Two Surfaces, Posterior$2740%$274 Medium
Flouride - Topical Varnish Application$450%$45 Medium
Problem Focused Evaluation - Limited to a Specific Oral Health Problem or Complaint$850%$85 Medium
Root Canal - Bicuspid Tooth$9210%$921 Medium
Sealant - Placed on Tooth Surface to Prevent Decay$610%$61 Medium
Tooth Extraction - Elevation and/or Forceps Removal$2520%$252 Medium
X-Ray - Additional Image of Tooth from Crown to Root from Inside Mouth$220%$22 Medium
X-Ray - Complete Intraoral Series$1440%$144 Medium
X-Ray - Four Images, Bitewings$760%$76 Medium
X-Ray - Intraoral, Periapical Radiographic Image$360%$36 Medium
X-Ray - Two Images, Bitewings$550%$55 Medium
X-Ray - Whole Mouth from Outside Mouth$1430%$143 Medium