Dracut Dental Group
465 Nashua Road Dracut, MA 01826
Dental Procedures
Preventive Care
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Adult Dental Cleaning | $135 | 0% | $135 | Medium |
| Child Dental Cleaning | $92 | 0% | $92 | Medium |
| Plaque and tartar removal from around teeth and gums-per quadrant | $362 | 0% | $362 | Medium |
| Sealant placed on the tooth surface to prevent decay | $79 | 0% | $79 | Medium |
| Topical fluoride varnish application | $50 | 0% | $50 | Medium |
Diagnostic Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Comprehensive Dental Exam | $103 | 0% | $103 | Medium |
| Periodic dental exam - established patient | $62 | 0% | $62 | Medium |
| Problem focused evaluation limited to a specific oral health problem or complaint | $100 | 0% | $100 | Medium |
| X-Ray Dental - Complete intraoral series | $191 | 0% | $191 | Medium |
| X-Ray Dental - Four images - bitewings | $97 | 0% | $97 | Medium |
| X-Ray Dental - Intraoral - periapical radiographic image | $46 | 0% | $46 | Medium |
| X-Ray Dental - Two images - bitewings | $71 | 0% | $71 | Medium |
| X-Ray Dental - Additional image of tooth from crown to root, from inside mouth | $27 | 0% | $27 | Medium |
| X-Ray Dental - Whole mouth, from outside mouth | $172 | 0% | $172 | 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 | $204 | 0% | $204 | Medium |
| Silver (Amalgam) Dental Filling - Two surfaces, primary or permanent | $288 | 0% | $288 | Medium |
| Silver (Amalgam) Dental Filling - Three surfaces, primary or permanent | $307 | 0% | $307 | Medium |
| White (Resin) Dental Filling - One surface, posterior | $242 | 0% | $242 | Medium |
| White (Resin) Dental Filling - Two surfaces, posterior | $320 | 0% | $320 | Medium |
| White (Resin) Dental Filling - One surface, anterior | $247 | 0% | $247 | Medium |
| White (Resin) Dental Filling - Three surfaces, posterior | $393 | 0% | $393 | Medium |
| White (Resin) Dental Filling - Two surfaces, anterior | $290 | 0% | $290 | Medium |
Orthodontic Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Orthodontic Treatment Visit (Periodic - as part of a contract) | $109 | 0% | $109 | Medium |
Other Dental Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Maintenance Therapy - Periodontal | $198 | 0% | $198 | Medium |
| Tooth Extraction (Elevation and/or forceps removal) | $231 | 0% | $231 | Medium |