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$1050%$105 Medium
Dental Cleaning - Child$1200%$120 Medium
Dental Exam - Comprehensive$900%$90 Medium
Dental Exam - Periodic, Established Patient$570%$57 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$1650%$165 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$2020%$202 Medium
Dental Filling - White (Resin): Two Surfaces, Posterior$2760%$276 Medium
Flouride - Topical Varnish Application$1010%$101 Medium
Fluoride - Topical Application$430%$43 Medium
Maintenance Therapy - Periodontal$1510%$151 Medium
Orthodontic Treatment - Periodic Visit, Part of a Contract$1430%$143 Medium
Plaque and Tartar Removal - Around Teeth and Gums, Per Quadrant$3950%$395 Medium
Problem Focused Evaluation - Limited to a Specific Oral Health Problem or Complaint$880%$88 Medium
Root Canal - Anterior Tooth$1,8020%$1,802 Medium
Root Canal - Bicuspid Tooth$9740%$974 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$1900%$190 Medium
X-Ray - Additional Image of Tooth from Crown to Root from Inside Mouth$320%$32 Medium
X-Ray - Complete Intraoral Series$1460%$146 Medium
X-Ray - Four Images, Bitewings$750%$75 Medium
X-Ray - Intraoral, Periapical Radiographic Image$340%$34 Medium
X-Ray - Two Images, Bitewings$760%$76 Medium