Capstone Dental Center

71 State Route 101a, Unit 7 Amherst, NH 03031
Dental Procedures
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ProcedureEstimate of Total Cost Uninsured Discount What You Will Pay Typical Patient Complexity
Dental Cleaning - Adult$1210%$121 Medium
Dental Cleaning - Child$890%$89 Medium
Dental Exam - Comprehensive$1040%$104 Medium
Dental Exam - Periodic, Established Patient$500%$50 Medium
Dental Filling - Silver (Amalgam): One Surface, Primary or Permanent$2150%$215 Medium
Dental Filling - Silver (Amalgam): Three Surfaces, Primary or Permanent$3510%$351 Medium
Dental Filling - Silver (Amalgam): Two Surfaces, Primary or Permanent$2840%$284 Medium
Dental Filling - White (Resin): One Surface, Anterior$1770%$177 Medium
Dental Filling - White (Resin): One Surface, Posterior$2150%$215 Medium
Dental Filling - White (Resin): Three Surfaces, Posterior$3660%$366 Medium
Dental Filling - White (Resin): Two Surfaces, Anterior$2120%$212 Medium
Dental Filling - White (Resin): Two Surfaces, Posterior$2840%$284 Medium
Flouride - Topical Varnish Application$540%$54 Medium
Fluoride - Topical Application$540%$54 Medium
Maintenance Therapy - Periodontal$1660%$166 Medium
Plaque and Tartar Removal - Around Teeth and Gums, Per Quadrant$2890%$289 Medium
Problem Focused Evaluation - Limited to a Specific Oral Health Problem or Complaint$960%$96 Medium
Sealant - Placed on Tooth Surface to Prevent Decay$580%$58 Medium
Tooth Extraction - Elevation and/or Forceps Removal$2310%$231 Medium
X-Ray - Additional Image of Tooth from Crown to Root from Inside Mouth$270%$27 Medium
X-Ray - Complete Intraoral Series$1500%$150 Medium
X-Ray - Four Images, Bitewings$720%$72 Medium
X-Ray - Intraoral, Periapical Radiographic Image$350%$35 Medium
X-Ray - Two Images, Bitewings$510%$51 Medium
X-Ray - Whole Mouth from Outside Mouth$1500%$150 Medium