Dibona Dental Group

19 Hampton Road Exeter, NH 03833
Dental Procedures
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ProcedureEstimate of Total Cost Uninsured Discount What You Will Pay Typical Patient Complexity
Dental Cleaning - Adult$1050%$105 Medium
Dental Cleaning - Child$840%$84 Medium
Dental Exam - Comprehensive$900%$90 Medium
Dental Exam - Periodic, Established Patient$530%$53 Medium
Dental Filling - Silver (Amalgam): One Surface, Primary or Permanent$1890%$189 Medium
Dental Filling - Silver (Amalgam): Three Surfaces, Primary or Permanent$2820%$282 Medium
Dental Filling - Silver (Amalgam): Two Surfaces, Primary or Permanent$2170%$217 Medium
Dental Filling - White (Resin): One Surface, Anterior$1640%$164 Medium
Dental Filling - White (Resin): One Surface, Posterior$1880%$188 Medium
Dental Filling - White (Resin): Three Surfaces, Posterior$2820%$282 Medium
Dental Filling - White (Resin): Two Surfaces, Anterior$1890%$189 Medium
Dental Filling - White (Resin): Two Surfaces, Posterior$2570%$257 Medium
Flouride - Topical Varnish Application$410%$41 Medium
Fluoride - Topical Application$420%$42 Medium
Maintenance Therapy - Periodontal$1510%$151 Medium
Orthodontic Treatment - Periodic Visit, Part of a Contract$1310%$131 Medium
Plaque and Tartar Removal - Around Teeth and Gums, Per Quadrant$2760%$276 Medium
Problem Focused Evaluation - Limited to a Specific Oral Health Problem or Complaint$740%$74 Medium
Root Canal - Anterior Tooth$8060%$806 Medium
Root Canal - Bicuspid Tooth$8200%$820 Medium
Root Canal - Molar$1,2190%$1,219 Medium
Sealant - Placed on Tooth Surface to Prevent Decay$580%$58 Medium
Tooth Extraction - Elevation and/or Forceps Removal$1820%$182 Medium
X-Ray - Additional Image of Tooth from Crown to Root from Inside Mouth$270%$27 Medium
X-Ray - Complete Intraoral Series$1460%$146 Medium
X-Ray - Four Images, Bitewings$740%$74 Medium
X-Ray - Intraoral, Periapical Radiographic Image$280%$28 Medium
X-Ray - Two Images, Bitewings$500%$50 Medium
X-Ray - Whole Mouth from Outside Mouth$1300%$130 Medium