Conway Village Dental
7 Greenwood Ave Streete 3 Conway, NH 03818
Dental Procedures
Preventive Care
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Adult Dental Cleaning | $100 | 0% | $100 | Medium |
| Child Dental Cleaning | $74 | 0% | $74 | Medium |
| Fluoride - Topical Application | $27 | 0% | $27 | Medium |
| Plaque and tartar removal from around teeth and gums-per quadrant | $275 | 0% | $275 | Medium |
| Sealant placed on the tooth surface to prevent decay | $57 | 0% | $57 | Medium |
| Topical fluoride varnish application | $27 | 0% | $27 | Medium |
Diagnostic Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Comprehensive Dental Exam | $98 | 0% | $98 | Medium |
| Periodic dental exam - established patient | $49 | 0% | $49 | Medium |
| Problem focused evaluation limited to a specific oral health problem or complaint | $88 | 0% | $88 | Medium |
| X-Ray Dental - Complete intraoral series | $163 | 0% | $163 | Medium |
| X-Ray Dental - Four images - bitewings | $77 | 0% | $77 | Medium |
| X-Ray Dental - Intraoral - periapical radiographic image | $35 | 0% | $35 | Medium |
| X-Ray Dental - Two images - bitewings | $56 | 0% | $56 | Medium |
| X-Ray Dental - Additional image of tooth from crown to root, from inside mouth | $27 | 0% | $27 | Medium |
| X-Ray Dental - Whole mouth, from outside mouth | $137 | 0% | $137 | 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 | $207 | 0% | $207 | Medium |
| Silver (Amalgam) Dental Filling - Two surfaces, primary or permanent | $275 | 0% | $275 | Medium |
| Silver (Amalgam) Dental Filling - Three surfaces, primary or permanent | $336 | 0% | $336 | Medium |
| White (Resin) Dental Filling - One surface, posterior | $207 | 0% | $207 | Medium |
| White (Resin) Dental Filling - Two surfaces, posterior | $275 | 0% | $275 | Medium |
| White (Resin) Dental Filling - One surface, anterior | $171 | 0% | $171 | Medium |
| White (Resin) Dental Filling - Three surfaces, posterior | $336 | 0% | $336 | Medium |
| White (Resin) Dental Filling - Two surfaces, anterior | $230 | 0% | $230 | Medium |
Other Dental Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Maintenance Therapy - Periodontal | $140 | 0% | $140 | Medium |
| Tooth Extraction (Elevation and/or forceps removal) | $182 | 0% | $182 | Medium |