David C. Frost, DMD
75 Clinton Street Concord, NH 03301
Dental Procedures
Preventive Care
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Adult Dental Cleaning | $126 | 0% | $126 | Medium |
| Child Dental Cleaning | $101 | 0% | $101 | Medium |
| Fluoride - Topical Application | $61 | 0% | $61 | Medium |
| Sealant placed on the tooth surface to prevent decay | $79 | 0% | $79 | Medium |
| Topical fluoride varnish application | $61 | 0% | $61 | Medium |
Diagnostic Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Periodic dental exam - established patient | $76 | 0% | $76 | Medium |
| Problem focused evaluation limited to a specific oral health problem or complaint | $121 | 0% | $121 | Medium |
| X-Ray Dental - Complete intraoral series | $196 | 0% | $196 | Medium |
| X-Ray Dental - Four images - bitewings | $139 | 0% | $139 | Medium |
| X-Ray Dental - Intraoral - periapical radiographic image | $48 | 0% | $48 | Medium |
| X-Ray Dental - Two images - bitewings | $92 | 0% | $92 | Medium |
| X-Ray Dental - Whole mouth, from outside mouth | $177 | 0% | $177 | 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 | $214 | 0% | $214 | Medium |
| Silver (Amalgam) Dental Filling - Two surfaces, primary or permanent | $250 | 0% | $250 | Medium |
| Silver (Amalgam) Dental Filling - Three surfaces, primary or permanent | $369 | 0% | $369 | Medium |
| White (Resin) Dental Filling - One surface, posterior | $251 | 0% | $251 | Medium |
| White (Resin) Dental Filling - Two surfaces, posterior | $330 | 0% | $330 | Medium |
| White (Resin) Dental Filling - One surface, anterior | $251 | 0% | $251 | Medium |
| White (Resin) Dental Filling - Two surfaces, anterior | $330 | 0% | $330 | Medium |