Dental Bright
Dental Procedures
| Procedure | Estimate of Total Cost | Uninsured Discount | What You Will Pay |
|---|---|---|---|
| Dental Cleaning - Adult | $138 | 0% | $138 |
| Dental Cleaning - Child | $118 | 0% | $118 |
| Dental Exam - Periodic, Established Patient | $69 | 0% | $69 |
| Dental Filling - White (Resin): One Surface, Posterior | $200 | 0% | $200 |
| Dental Filling - White (Resin): Three Surfaces, Posterior | $315 | 0% | $315 |
| Dental Filling - White (Resin): Two Surfaces, Posterior | $271 | 0% | $271 |
| Fluoride - Topical Application | $71 | 0% | $71 |
| Maintenance Therapy - Periodontal | $231 | 0% | $231 |
| Tooth Extraction - Elevation and/or Forceps Removal | $175 | 0% | $175 |
| X-Ray - Additional Image of Tooth from Crown to Root from Inside Mouth | $34 | 0% | $34 |
| X-Ray - Four Images, Bitewings | $84 | 0% | $84 |
| X-Ray - Intraoral, Periapical Radiographic Image | $38 | 0% | $38 |
| X-Ray - Two Images, Bitewings | $63 | 0% | $63 |
| X-Ray - Whole Mouth from Outside Mouth | $147 | 0% | $147 |