Charles Kokinos, DDS
54 Church Street Lowell, MA 01852
Dental Procedures
| Procedure | Estimate of Total Cost | Uninsured Discount | What You Will Pay |
|---|---|---|---|
| Dental Cleaning - Adult | $145 | 0% | $145 |
| Dental Cleaning - Child | $118 | 0% | $118 |
| Dental Exam - Periodic, Established Patient | $58 | 0% | $58 |
| Dental Filling - Silver (Amalgam): One Surface, Primary or Permanent | $173 | 0% | $173 |
| Dental Filling - Silver (Amalgam): Two Surfaces, Primary or Permanent | $173 | 0% | $173 |
| Dental Filling - White (Resin): One Surface, Anterior | $152 | 0% | $152 |
| Fluoride - Topical Application | $71 | 0% | $71 |
| Maintenance Therapy - Periodontal | $193 | 0% | $193 |
| Plaque and Tartar Removal - Around Teeth and Gums, Per Quadrant | $242 | 0% | $242 |
| Root Canal - Anterior Tooth | $840 | 0% | $840 |
| Tooth Extraction - Elevation and/or Forceps Removal | $191 | 0% | $191 |
| X-Ray - Additional Image of Tooth from Crown to Root from Inside Mouth | $26 | 0% | $26 |
| X-Ray - Complete Intraoral Series | $180 | 0% | $180 |
| X-Ray - Four Images, Bitewings | $87 | 0% | $87 |
| X-Ray - Intraoral, Periapical Radiographic Image | $38 | 0% | $38 |
| X-Ray - Two Images, Bitewings | $63 | 0% | $63 |