Dental Associates of Lowell
163 Pine Street Lowell, MA 01851
Dental Procedures
Preventive Care
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Adult Dental Cleaning | $116 | 0% | $116 | Medium |
| Child Dental Cleaning | $84 | 0% | $84 | Medium |
| Fluoride - Topical Application | $42 | 0% | $42 | Medium |
| Plaque and tartar removal from around teeth and gums-per quadrant | $289 | 0% | $289 | Medium |
| Sealant placed on the tooth surface to prevent decay | $74 | 0% | $74 | Medium |
Diagnostic Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Comprehensive Dental Exam | $74 | 0% | $74 | Medium |
| Periodic dental exam - established patient | $53 | 0% | $53 | Medium |
| Problem focused evaluation limited to a specific oral health problem or complaint | $84 | 0% | $84 | Medium |
| X-Ray Dental - Complete intraoral series | $204 | 0% | $204 | Medium |
| X-Ray Dental - Four images - bitewings | $71 | 0% | $71 | Medium |
| X-Ray Dental - Intraoral - periapical radiographic image | $26 | 0% | $26 | Medium |
| X-Ray Dental - Two images - bitewings | $53 | 0% | $53 | Medium |
| X-Ray Dental - Additional image of tooth from crown to root, from inside mouth | $22 | 0% | $22 | Medium |
| X-Ray Dental - Whole mouth, from outside mouth | $131 | 0% | $131 | 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 | $179 | 0% | $179 | Medium |
| Silver (Amalgam) Dental Filling - Two surfaces, primary or permanent | $184 | 0% | $184 | Medium |
| Silver (Amalgam) Dental Filling - Three surfaces, primary or permanent | $194 | 0% | $194 | Medium |
| White (Resin) Dental Filling - One surface, posterior | $189 | 0% | $189 | Medium |
| White (Resin) Dental Filling - Two surfaces, posterior | $208 | 0% | $208 | Medium |
| White (Resin) Dental Filling - One surface, anterior | $179 | 0% | $179 | Medium |
| White (Resin) Dental Filling - Two surfaces, anterior | $205 | 0% | $205 | Medium |
Other Dental Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Tooth Extraction (Elevation and/or forceps removal) | $194 | 0% | $194 | Medium |