Brian Seth Spigel, DDS
109 Summer Street, Suite 4 Springfield, VT 05156
Dental Procedures
Preventive Care
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Adult Dental Cleaning | $84 | 0% | $84 | Medium |
| Child Dental Cleaning | $68 | 0% | $68 | Medium |
| Fluoride - Topical Application | $35 | 0% | $35 | Medium |
| Sealant placed on the tooth surface to prevent decay | $53 | 0% | $53 | Medium |
| Topical fluoride varnish application | $40 | 0% | $40 | Medium |
Diagnostic Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Comprehensive Dental Exam | $74 | 0% | $74 | Medium |
| Periodic dental exam - established patient | $38 | 0% | $38 | Medium |
| Problem focused evaluation limited to a specific oral health problem or complaint | $74 | 0% | $74 | Medium |
| X-Ray Dental - Intraoral - periapical radiographic image | $26 | 0% | $26 | Medium |
| X-Ray Dental - Two images - bitewings | $40 | 0% | $40 | Medium |
| X-Ray Dental - Additional image of tooth from crown to root, from inside mouth | $26 | 0% | $26 | Medium |
| X-Ray Dental - Whole mouth, from outside mouth | $105 | 0% | $105 | 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 | $131 | 0% | $131 | Medium |
| Silver (Amalgam) Dental Filling - Two surfaces, primary or permanent | $168 | 0% | $168 | Medium |
| Silver (Amalgam) Dental Filling - Three surfaces, primary or permanent | $194 | 0% | $194 | Medium |
| White (Resin) Dental Filling - One surface, posterior | $158 | 0% | $158 | Medium |
| White (Resin) Dental Filling - Two surfaces, posterior | $200 | 0% | $200 | Medium |
| White (Resin) Dental Filling - One surface, anterior | $147 | 0% | $147 | Medium |
| White (Resin) Dental Filling - Three surfaces, posterior | $247 | 0% | $247 | Medium |
| White (Resin) Dental Filling - Two surfaces, anterior | $189 | 0% | $189 | Medium |