Cedric H Dustin, DDS
47 Main Street Pittsfield, NH 03263
Dental Procedures
| Procedure | Estimate of Total Cost | Uninsured Discount | What You Will Pay |
|---|---|---|---|
| Dental Cleaning - Adult | $86 | 0% | $86 |
| Dental Cleaning - Child | $67 | 0% | $67 |
| Dental Exam - Periodic, Established Patient | $42 | 0% | $42 |
| Dental Filling - Silver (Amalgam): One Surface, Primary or Permanent | $231 | 0% | $231 |
| Dental Filling - Silver (Amalgam): Three Surfaces, Primary or Permanent | $336 | 0% | $336 |
| Dental Filling - Silver (Amalgam): Two Surfaces, Primary or Permanent | $284 | 0% | $284 |
| Dental Filling - White (Resin): One Surface, Anterior | $263 | 0% | $263 |
| Dental Filling - White (Resin): One Surface, Posterior | $294 | 0% | $294 |
| Dental Filling - White (Resin): Two Surfaces, Posterior | $368 | 0% | $368 |
| Flouride - Topical Varnish Application | $32 | 0% | $32 |
| Sealant - Placed on Tooth Surface to Prevent Decay | $42 | 0% | $42 |
| X-Ray - Complete Intraoral Series | $210 | 0% | $210 |
| X-Ray - Intraoral, Periapical Radiographic Image | $21 | 0% | $21 |
| X-Ray - Two Images, Bitewings | $74 | 0% | $74 |