Don Wong Kim Family Dental Care
465 South Broadway Lawrence, MA 01843
Dental Procedures
Preventive Care
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Adult Dental Cleaning | $126 | 0% | $126 | Medium |
| Child Dental Cleaning | $89 | 0% | $89 | Medium |
| Fluoride - Topical Application | $47 | 0% | $47 | Medium |
| Sealant placed on the tooth surface to prevent decay | $74 | 0% | $74 | Medium |
Diagnostic Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Comprehensive Dental Exam | $84 | 0% | $84 | Medium |
| Periodic dental exam - established patient | $53 | 0% | $53 | Medium |
| Problem focused evaluation limited to a specific oral health problem or complaint | $95 | 0% | $95 | Medium |
| X-Ray Dental - Complete intraoral series | $215 | 0% | $215 | Medium |
| X-Ray Dental - Four images - bitewings | $84 | 0% | $84 | Medium |
| X-Ray Dental - Intraoral - periapical radiographic image | $35 | 0% | $35 | Medium |
| X-Ray Dental - Additional image of tooth from crown to root, from inside mouth | $50 | 0% | $50 | Medium |
| X-Ray Dental - Whole mouth, from outside mouth | $142 | 0% | $142 | Medium |
Dental Fillings
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Silver (Amalgam) Dental Filling - Two surfaces, primary or permanent | $227 | 0% | $227 | Medium |
| White (Resin) Dental Filling - One surface, posterior | $221 | 0% | $221 | Medium |
| White (Resin) Dental Filling - Two surfaces, posterior | $247 | 0% | $247 | Medium |
| White (Resin) Dental Filling - One surface, anterior | $194 | 0% | $194 | Medium |
Other Dental Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Tooth Extraction (Elevation and/or forceps removal) | $191 | 0% | $191 | Medium |