Community Dentists of Lowell
Dental Procedures
| Procedure | Estimate of Total Cost | Uninsured Discount | What You Will Pay |
|---|---|---|---|
| Dental Cleaning - Adult | $100 | 0% | $100 |
| Dental Cleaning - Child | $84 | 0% | $84 |
| Dental Exam - Comprehensive | $74 | 0% | $74 |
| Dental Exam - Periodic, Established Patient | $53 | 0% | $53 |
| Dental Filling - Silver (Amalgam): One Surface, Primary or Permanent | $185 | 0% | $185 |
| Dental Filling - Silver (Amalgam): Three Surfaces, Primary or Permanent | $290 | 0% | $290 |
| Dental Filling - White (Resin): One Surface, Anterior | $214 | 0% | $214 |
| Dental Filling - White (Resin): One Surface, Posterior | $184 | 0% | $184 |
| Dental Filling - White (Resin): Two Surfaces, Posterior | $208 | 0% | $208 |
| Fluoride - Topical Application | $42 | 0% | $42 |
| X-Ray - Additional Image of Tooth from Crown to Root from Inside Mouth | $23 | 0% | $23 |
| X-Ray - Complete Intraoral Series | $126 | 0% | $126 |
| X-Ray - Four Images, Bitewings | $74 | 0% | $74 |
| X-Ray - Intraoral, Periapical Radiographic Image | $32 | 0% | $32 |
| X-Ray - Two Images, Bitewings | $42 | 0% | $42 |
| X-Ray - Whole Mouth from Outside Mouth | $121 | 0% | $121 |