Coleman Family Dental Care
1 Overlook Drive Amherst, NH 03031
Dental Procedures
Preventive Care
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Adult Dental Cleaning | $110 | 0% | $110 | Medium |
| Child Dental Cleaning | $88 | 0% | $88 | Medium |
| Fluoride - Topical Application | $45 | 0% | $45 | Medium |
| Plaque and tartar removal from around teeth and gums-per quadrant | $314 | 0% | $314 | Medium |
| Sealant placed on the tooth surface to prevent decay | $62 | 0% | $62 | Medium |
Diagnostic Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Comprehensive Dental Exam | $101 | 0% | $101 | Medium |
| Periodic dental exam - established patient | $61 | 0% | $61 | Medium |
| Problem focused evaluation limited to a specific oral health problem or complaint | $95 | 0% | $95 | Medium |
| X-Ray Dental - Complete intraoral series | $171 | 0% | $171 | Medium |
| X-Ray Dental - Four images - bitewings | $81 | 0% | $81 | Medium |
| X-Ray Dental - Intraoral - periapical radiographic image | $36 | 0% | $36 | 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 |
| X-Ray Dental - Whole mouth, from outside mouth | $166 | 0% | $166 | 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 | $181 | 0% | $181 | Medium |
| Silver (Amalgam) Dental Filling - Two surfaces, primary or permanent | $218 | 0% | $218 | Medium |
| Silver (Amalgam) Dental Filling - Three surfaces, primary or permanent | $255 | 0% | $255 | Medium |
| White (Resin) Dental Filling - One surface, posterior | $228 | 0% | $228 | Medium |
| White (Resin) Dental Filling - Two surfaces, posterior | $281 | 0% | $281 | Medium |
| White (Resin) Dental Filling - One surface, anterior | $208 | 0% | $208 | Medium |
| White (Resin) Dental Filling - Three surfaces, posterior | $355 | 0% | $355 | Medium |
| White (Resin) Dental Filling - Two surfaces, anterior | $238 | 0% | $238 | Medium |
Other Dental Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Maintenance Therapy - Periodontal | $161 | 0% | $161 | Medium |
| Tooth Extraction (Elevation and/or forceps removal) | $194 | 0% | $194 | Medium |