Calvin Dental Associates

25 Buttrick Road Londonderry, NH 03053
Dental Procedures
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ProcedureEstimate of Total Cost Uninsured Discount What You Will Pay Typical Patient Complexity
Dental Cleaning - Adult$1350%$135 Medium
Dental Cleaning - Child$1100%$110 Medium
Dental Exam - Comprehensive$1580%$158 Medium
Dental Exam - Periodic, Established Patient$700%$70 Medium
Dental Filling - Silver (Amalgam): One Surface, Primary or Permanent$2360%$236 Medium
Dental Filling - Silver (Amalgam): Three Surfaces, Primary or Permanent$3730%$373 Medium
Dental Filling - Silver (Amalgam): Two Surfaces, Primary or Permanent$3100%$310 Medium
Dental Filling - White (Resin): One Surface, Anterior$2360%$236 Medium
Dental Filling - White (Resin): One Surface, Posterior$2360%$236 Medium
Dental Filling - White (Resin): Three Surfaces, Posterior$3730%$373 Medium
Dental Filling - White (Resin): Two Surfaces, Anterior$2780%$278 Medium
Dental Filling - White (Resin): Two Surfaces, Posterior$3100%$310 Medium
Fluoride - Topical Application$550%$55 Medium
Maintenance Therapy - Periodontal$2000%$200 Medium
Plaque and Tartar Removal - Around Teeth and Gums, Per Quadrant$3410%$341 Medium
Problem Focused Evaluation - Limited to a Specific Oral Health Problem or Complaint$1260%$126 Medium
Root Canal - Anterior Tooth$1,0760%$1,076 Medium
Root Canal - Bicuspid Tooth$1,1810%$1,181 Medium
Sealant - Placed on Tooth Surface to Prevent Decay$630%$63 Medium
Tooth Extraction - Elevation and/or Forceps Removal$3100%$310 Medium
X-Ray - Additional Image of Tooth from Crown to Root from Inside Mouth$320%$32 Medium
X-Ray - Complete Intraoral Series$1790%$179 Medium
X-Ray - Four Images, Bitewings$890%$89 Medium
X-Ray - Intraoral, Periapical Radiographic Image$420%$42 Medium
X-Ray - Two Images, Bitewings$600%$60 Medium
X-Ray - Whole Mouth from Outside Mouth$1790%$179 Medium