Capitol Center For Oral & Maxillofacial Surgery
Dental Procedures
| Procedure | Estimate of Total Cost | Uninsured Discount | What You Will Pay |
|---|---|---|---|
| Dental Exam - Comprehensive | $108 | 0% | $108 |
| Dental Exam - Periodic, Established Patient | $108 | 0% | $108 |
| Problem Focused Evaluation - Limited to a Specific Oral Health Problem or Complaint | $108 | 0% | $108 |
| Tooth Extraction - Elevation and/or Forceps Removal | $218 | 0% | $218 |
| X-Ray - Whole Mouth from Outside Mouth | $153 | 0% | $153 |