Charles Kokinos, DDS
54 Church Street Lowell, MA 01852
Dental Procedures
Preventive Care
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Adult Dental Cleaning | $145 | 0% | $145 | Medium |
| Child Dental Cleaning | $118 | 0% | $118 | Medium |
| Fluoride - Topical Application | $71 | 0% | $71 | Medium |
Diagnostic Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Periodic dental exam - established patient | $69 | 0% | $69 | Medium |
| X-Ray Dental - Complete intraoral series | $163 | 0% | $163 | Medium |
| X-Ray Dental - Four images - bitewings | $84 | 0% | $84 | Medium |
| X-Ray Dental - Intraoral - periapical radiographic image | $32 | 0% | $32 | Medium |
| X-Ray Dental - Two images - bitewings | $63 | 0% | $63 | Medium |
| X-Ray Dental - Additional image of tooth from crown to root, from inside mouth | $34 | 0% | $34 | Medium |
Dental Fillings
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Silver (Amalgam) Dental Filling - Two surfaces, primary or permanent | $173 | 0% | $173 | Medium |
| White (Resin) Dental Filling - One surface, posterior | $221 | 0% | $221 | Medium |
| White (Resin) Dental Filling - One surface, anterior | $152 | 0% | $152 | Medium |
| White (Resin) Dental Filling - Two surfaces, anterior | $269 | 0% | $269 | Medium |
Other Dental Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Maintenance Therapy - Periodontal | $193 | 0% | $193 | Medium |
| Tooth Extraction (Elevation and/or forceps removal) | $191 | 0% | $191 | Medium |