Donald R. Welsh Jr., DMD
320 Union Street Portsmouth, NH 03801
Dental Procedures
Preventive Care
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Adult Dental Cleaning | $104 | 0% | $104 | Medium |
| Child Dental Cleaning | $84 | 0% | $84 | Medium |
| Fluoride - Topical Application | $40 | 0% | $40 | Medium |
| Sealant placed on the tooth surface to prevent decay | $56 | 0% | $56 | Medium |
| Topical fluoride varnish application | $42 | 0% | $42 | Medium |
Diagnostic Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Comprehensive Dental Exam | $158 | 0% | $158 | Medium |
| Periodic dental exam - established patient | $49 | 0% | $49 | Medium |
| Problem focused evaluation limited to a specific oral health problem or complaint | $74 | 0% | $74 | Medium |
| X-Ray Dental - Complete intraoral series | $152 | 0% | $152 | Medium |
| X-Ray Dental - Four images - bitewings | $63 | 0% | $63 | Medium |
| X-Ray Dental - Intraoral - periapical radiographic image | $32 | 0% | $32 | Medium |
| X-Ray Dental - Two images - bitewings | $50 | 0% | $50 | Medium |
| X-Ray Dental - Additional image of tooth from crown to root, from inside mouth | $29 | 0% | $29 | 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 - One surface, primary or permanent | $236 | 0% | $236 | Medium |
| Silver (Amalgam) Dental Filling - Two surfaces, primary or permanent | $268 | 0% | $268 | Medium |
| Silver (Amalgam) Dental Filling - Three surfaces, primary or permanent | $347 | 0% | $347 | Medium |
| White (Resin) Dental Filling - One surface, posterior | $236 | 0% | $236 | Medium |
| White (Resin) Dental Filling - Two surfaces, posterior | $268 | 0% | $268 | Medium |
| White (Resin) Dental Filling - One surface, anterior | $196 | 0% | $196 | Medium |
| White (Resin) Dental Filling - Three surfaces, posterior | $347 | 0% | $347 | Medium |
| White (Resin) Dental Filling - Two surfaces, anterior | $203 | 0% | $203 | Medium |
Other Dental Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Maintenance Therapy - Periodontal | $142 | 0% | $142 | Medium |