Dental Health Concepts
Dental Procedures
| Procedure | Estimate of Total Cost | Uninsured Discount | What You Will Pay |
|---|---|---|---|
| Dental Cleaning - Adult | $124 | 0% | $124 |
| Dental Cleaning - Child | $100 | 0% | $100 |
| Dental Exam - Periodic, Established Patient | $63 | 0% | $63 |
| Dental Filling - Silver (Amalgam): One Surface, Primary or Permanent | $222 | 0% | $222 |
| Dental Filling - White (Resin): One Surface, Anterior | $215 | 0% | $215 |
| Dental Filling - White (Resin): One Surface, Posterior | $226 | 0% | $226 |
| Dental Filling - White (Resin): Three Surfaces, Posterior | $364 | 0% | $364 |
| Dental Filling - White (Resin): Two Surfaces, Anterior | $251 | 0% | $251 |
| Dental Filling - White (Resin): Two Surfaces, Posterior | $299 | 0% | $299 |
| Maintenance Therapy - Periodontal | $179 | 0% | $179 |
| X-Ray - Additional Image of Tooth from Crown to Root from Inside Mouth | $27 | 0% | $27 |
| X-Ray - Complete Intraoral Series | $192 | 0% | $192 |
| X-Ray - Four Images, Bitewings | $85 | 0% | $85 |
| X-Ray - Intraoral, Periapical Radiographic Image | $41 | 0% | $41 |
| X-Ray - Two Images, Bitewings | $64 | 0% | $64 |
| X-Ray - Whole Mouth from Outside Mouth | $144 | 0% | $144 |