Dental Cleaning - Adult | $131 | 0% | $131 |
Dental Cleaning - Child | $117 | 0% | $117 |
Dental Exam - Periodic, Established Patient | $78 | 0% | $78 |
Dental Filling - Silver (Amalgam): One Surface, Primary or Permanent | $222 | 0% | $222 |
Dental Filling - Silver (Amalgam): Three Surfaces, Primary or Permanent | $458 | 0% | $458 |
Dental Filling - Silver (Amalgam): Two Surfaces, Primary or Permanent | $303 | 0% | $303 |
Dental Filling - White (Resin): One Surface, Anterior | $263 | 0% | $263 |
Dental Filling - White (Resin): One Surface, Posterior | $263 | 0% | $263 |
Dental Filling - White (Resin): Three Surfaces, Posterior | $458 | 0% | $458 |
Dental Filling - White (Resin): Two Surfaces, Anterior | $345 | 0% | $345 |
Dental Filling - White (Resin): Two Surfaces, Posterior | $345 | 0% | $345 |
Flouride - Topical Varnish Application | $51 | 0% | $51 |
Fluoride - Topical Application | $51 | 0% | $51 |
Maintenance Therapy - Periodontal | $177 | 0% | $177 |
Problem Focused Evaluation - Limited to a Specific Oral Health Problem or Complaint | $126 | 0% | $126 |
Sealant - Placed on Tooth Surface to Prevent Decay | $81 | 0% | $81 |
X-Ray - Additional Image of Tooth from Crown to Root from Inside Mouth | $47 | 0% | $47 |
X-Ray - Complete Intraoral Series | $198 | 0% | $198 |
X-Ray - Four Images, Bitewings | $147 | 0% | $147 |
X-Ray - Intraoral, Periapical Radiographic Image | $50 | 0% | $50 |
X-Ray - Two Images, Bitewings | $97 | 0% | $97 |