Carolyn A Madison, DMD
3 Cherry Street Newburyport, MA 01950
Dental Procedures
Preventive Care
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Adult Dental Cleaning | $131 | 0% | $131 | Medium |
| Child Dental Cleaning | $99 | 0% | $99 | Medium |
| Topical fluoride varnish application | $55 | 0% | $55 | Medium |
Diagnostic Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Comprehensive Dental Exam | $202 | 0% | $202 | Medium |
| Periodic dental exam - established patient | $70 | 0% | $70 | Medium |
| Problem focused evaluation limited to a specific oral health problem or complaint | $109 | 0% | $109 | Medium |
| X-Ray Dental - Complete intraoral series | $179 | 0% | $179 | Medium |
| X-Ray Dental - Four images - bitewings | $88 | 0% | $88 | Medium |
| X-Ray Dental - Intraoral - periapical radiographic image | $48 | 0% | $48 | Medium |
| X-Ray Dental - Additional image of tooth from crown to root, from inside mouth | $48 | 0% | $48 | Medium |
| X-Ray Dental - Whole mouth, from outside mouth | $173 | 0% | $173 | Medium |
Dental Fillings
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Silver (Amalgam) Dental Filling - One surface, primary or permanent | $194 | 0% | $194 | Medium |
| Silver (Amalgam) Dental Filling - Two surfaces, primary or permanent | $256 | 0% | $256 | Medium |
| White (Resin) Dental Filling - One surface, posterior | $191 | 0% | $191 | Medium |
| White (Resin) Dental Filling - Two surfaces, posterior | $260 | 0% | $260 | Medium |
| White (Resin) Dental Filling - One surface, anterior | $191 | 0% | $191 | Medium |
| White (Resin) Dental Filling - Three surfaces, posterior | $307 | 0% | $307 | Medium |
| White (Resin) Dental Filling - Two surfaces, anterior | $202 | 0% | $202 | Medium |