Donald M. Dumais, DDS

155 Dow Street, Suite 401 Manchester, NH 03101
Dental Procedures
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My Health Insurance:

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ProcedureEstimate of Total Cost Uninsured Discount What You Will Pay Typical Patient Complexity
Dental Cleaning - Adult$1070%$107 Medium
Dental Cleaning - Child$890%$89 Medium
Dental Exam - Comprehensive$910%$91 Medium
Dental Exam - Periodic, Established Patient$540%$54 Medium
Dental Filling - Silver (Amalgam): One Surface, Primary or Permanent$1890%$189 Medium
Dental Filling - Silver (Amalgam): Three Surfaces, Primary or Permanent$3260%$326 Medium
Dental Filling - Silver (Amalgam): Two Surfaces, Primary or Permanent$2630%$263 Medium
Dental Filling - White (Resin): One Surface, Anterior$1670%$167 Medium
Dental Filling - White (Resin): One Surface, Posterior$1890%$189 Medium
Dental Filling - White (Resin): Three Surfaces, Posterior$3910%$391 Medium
Dental Filling - White (Resin): Two Surfaces, Anterior$2710%$271 Medium
Dental Filling - White (Resin): Two Surfaces, Posterior$2630%$263 Medium
Flouride - Topical Varnish Application$1010%$101 Medium
Fluoride - Topical Application$430%$43 Medium
Maintenance Therapy - Periodontal$1530%$153 Medium
Orthodontic Treatment - Periodic Visit, Part of a Contract$1430%$143 Medium
Plaque and Tartar Removal - Around Teeth and Gums, Per Quadrant$2800%$280 Medium
Problem Focused Evaluation - Limited to a Specific Oral Health Problem or Complaint$890%$89 Medium
Root Canal - Anterior Tooth$1,3510%$1,351 Medium
Root Canal - Bicuspid Tooth$9790%$979 Medium
Root Canal - Molar$1,2190%$1,219 Medium
Sealant - Placed on Tooth Surface to Prevent Decay$630%$63 Medium
Tooth Extraction - Elevation and/or Forceps Removal$1860%$186 Medium
X-Ray - Additional Image of Tooth from Crown to Root from Inside Mouth$230%$23 Medium
X-Ray - Complete Intraoral Series$1490%$149 Medium
X-Ray - Four Images, Bitewings$750%$75 Medium
X-Ray - Intraoral, Periapical Radiographic Image$380%$38 Medium
X-Ray - Two Images, Bitewings$540%$54 Medium