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
Dental Cleaning - Adult$1210%$121
Dental Cleaning - Child$890%$89
Dental Exam - Comprehensive$1040%$104
Dental Exam - Periodic, Established Patient$500%$50
Dental Filling - Silver (Amalgam): One Surface, Primary or Permanent$2150%$215
Dental Filling - Silver (Amalgam): Three Surfaces, Primary or Permanent$3660%$366
Dental Filling - Silver (Amalgam): Two Surfaces, Primary or Permanent$2840%$284
Dental Filling - White (Resin): One Surface, Anterior$1870%$187
Dental Filling - White (Resin): One Surface, Posterior$2150%$215
Dental Filling - White (Resin): Three Surfaces, Posterior$3660%$366
Dental Filling - White (Resin): Two Surfaces, Anterior$2310%$231
Dental Filling - White (Resin): Two Surfaces, Posterior$2840%$284
Flouride - Topical Varnish Application$540%$54
Fluoride - Topical Application$540%$54
Maintenance Therapy - Periodontal$1660%$166
Orthodontic Treatment - Periodic Visit, Part of a Contract$1750%$175
Plaque and Tartar Removal - Around Teeth and Gums, Per Quadrant$2950%$295
Problem Focused Evaluation - Limited to a Specific Oral Health Problem or Complaint$960%$96
Sealant - Placed on Tooth Surface to Prevent Decay$580%$58
Tooth Extraction - Elevation and/or Forceps Removal$2380%$238
X-Ray - Additional Image of Tooth from Crown to Root from Inside Mouth$270%$27
X-Ray - Complete Intraoral Series$1500%$150
X-Ray - Four Images, Bitewings$720%$72
X-Ray - Intraoral, Periapical Radiographic Image$350%$35
X-Ray - Two Images, Bitewings$510%$51
X-Ray - Whole Mouth from Outside Mouth$1500%$150