Dibona Dental Group

19 Hampton Road Exeter, NH 03833
Dental Procedures
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My Health Insurance:

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ProcedureEstimate of Total Cost Uninsured Discount What You Will Pay
Dental Cleaning - Adult$1090%$109
Dental Cleaning - Child$880%$88
Dental Exam - Comprehensive$910%$91
Dental Exam - Periodic, Established Patient$560%$56
Dental Filling - Silver (Amalgam): One Surface, Primary or Permanent$2010%$201
Dental Filling - Silver (Amalgam): Three Surfaces, Primary or Permanent$3420%$342
Dental Filling - Silver (Amalgam): Two Surfaces, Primary or Permanent$2630%$263
Dental Filling - White (Resin): One Surface, Anterior$1690%$169
Dental Filling - White (Resin): One Surface, Posterior$2010%$201
Dental Filling - White (Resin): Three Surfaces, Posterior$3420%$342
Dental Filling - White (Resin): Two Surfaces, Anterior$2030%$203
Dental Filling - White (Resin): Two Surfaces, Posterior$2630%$263
Flouride - Topical Varnish Application$500%$50
Maintenance Therapy - Periodontal$1510%$151
Plaque and Tartar Removal - Around Teeth and Gums, Per Quadrant$2890%$289
Problem Focused Evaluation - Limited to a Specific Oral Health Problem or Complaint$750%$75
Root Canal - Anterior Tooth$8060%$806
Root Canal - Bicuspid Tooth$8200%$820
Sealant - Placed on Tooth Surface to Prevent Decay$610%$61
Tooth Extraction - Elevation and/or Forceps Removal$1860%$186
X-Ray - Additional Image of Tooth from Crown to Root from Inside Mouth$270%$27
X-Ray - Complete Intraoral Series$1480%$148
X-Ray - Four Images, Bitewings$750%$75
X-Ray - Intraoral, Periapical Radiographic Image$330%$33
X-Ray - Two Images, Bitewings$510%$51
X-Ray - Whole Mouth from Outside Mouth$1370%$137