Carolyn A Madison, DMD
3 Cherry Street Newburyport, MA 01950
Dental Procedures
| Procedure | Estimate of Total Cost | Uninsured Discount | What You Will Pay |
|---|---|---|---|
| Dental Cleaning - Adult | $133 | 0% | $133 |
| Dental Cleaning - Child | $200 | 0% | $200 |
| Dental Exam - Comprehensive | $107 | 0% | $107 |
| Dental Exam - Periodic, Established Patient | $71 | 0% | $71 |
| Dental Filling - Silver (Amalgam): One Surface, Primary or Permanent | $389 | 0% | $389 |
| Dental Filling - Silver (Amalgam): Two Surfaces, Primary or Permanent | $521 | 0% | $521 |
| Dental Filling - White (Resin): One Surface, Posterior | $292 | 0% | $292 |
| Dental Filling - White (Resin): Three Surfaces, Posterior | $309 | 0% | $309 |
| Dental Filling - White (Resin): Two Surfaces, Anterior | $204 | 0% | $204 |
| Dental Filling - White (Resin): Two Surfaces, Posterior | $263 | 0% | $263 |
| Flouride - Topical Varnish Application | $57 | 0% | $57 |
| Problem Focused Evaluation - Limited to a Specific Oral Health Problem or Complaint | $120 | 0% | $120 |
| X-Ray - Complete Intraoral Series | $181 | 0% | $181 |
| X-Ray - Four Images, Bitewings | $90 | 0% | $90 |
| X-Ray - Intraoral, Periapical Radiographic Image | $50 | 0% | $50 |