Dentcare
Dental Procedures
| Procedure | Estimate of Total Cost | Uninsured Discount | What You Will Pay |
|---|---|---|---|
| Dental Cleaning - Adult | $116 | 0% | $116 |
| Dental Cleaning - Child | $89 | 0% | $89 |
| Dental Exam - Periodic, Established Patient | $53 | 0% | $53 |
| Dental Filling - Silver (Amalgam): Three Surfaces, Primary or Permanent | $236 | 0% | $236 |
| Dental Filling - White (Resin): One Surface, Posterior | $236 | 0% | $236 |
| Dental Filling - White (Resin): Three Surfaces, Posterior | $263 | 0% | $263 |
| Dental Filling - White (Resin): Two Surfaces, Anterior | $247 | 0% | $247 |
| Dental Filling - White (Resin): Two Surfaces, Posterior | $252 | 0% | $252 |
| Fluoride - Topical Application | $37 | 0% | $37 |
| X-Ray - Additional Image of Tooth from Crown to Root from Inside Mouth | $21 | 0% | $21 |
| X-Ray - Complete Intraoral Series | $142 | 0% | $142 |
| X-Ray - Four Images, Bitewings | $79 | 0% | $79 |
| X-Ray - Intraoral, Periapical Radiographic Image | $21 | 0% | $21 |