Dental Procedures
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ProcedureEstimate of Total Cost Uninsured Discount What You Will Pay Typical Patient Complexity
Dental Cleaning - Adult$1030%$103 Medium
Dental Cleaning - Child$830%$83 Medium
Dental Exam - Comprehensive$890%$89 Medium
Dental Exam - Periodic, Established Patient$490%$49 Medium
Dental Filling - Silver (Amalgam): One Surface, Primary or Permanent$1860%$186 Medium
Dental Filling - Silver (Amalgam): Three Surfaces, Primary or Permanent$2360%$236 Medium
Dental Filling - Silver (Amalgam): Two Surfaces, Primary or Permanent$1840%$184 Medium
Dental Filling - White (Resin): One Surface, Anterior$1370%$137 Medium
Dental Filling - White (Resin): One Surface, Posterior$1580%$158 Medium
Dental Filling - White (Resin): Three Surfaces, Posterior$2870%$287 Medium
Dental Filling - White (Resin): Two Surfaces, Anterior$1630%$163 Medium
Dental Filling - White (Resin): Two Surfaces, Posterior$2590%$259 Medium
Flouride - Topical Varnish Application$350%$35 Medium
Fluoride - Topical Application$430%$43 Medium
Maintenance Therapy - Periodontal$1490%$149 Medium
Plaque and Tartar Removal - Around Teeth and Gums, Per Quadrant$2720%$272 Medium
Problem Focused Evaluation - Limited to a Specific Oral Health Problem or Complaint$870%$87 Medium
Root Canal - Anterior Tooth$8390%$839 Medium
Root Canal - Bicuspid Tooth$9450%$945 Medium
Sealant - Placed on Tooth Surface to Prevent Decay$570%$57 Medium
Tooth Extraction - Elevation and/or Forceps Removal$1630%$163 Medium
X-Ray - Additional Image of Tooth from Crown to Root from Inside Mouth$270%$27 Medium
X-Ray - Complete Intraoral Series$1440%$144 Medium
X-Ray - Four Images, Bitewings$700%$70 Medium
X-Ray - Intraoral, Periapical Radiographic Image$260%$26 Medium
X-Ray - Two Images, Bitewings$700%$70 Medium
X-Ray - Whole Mouth from Outside Mouth$1860%$186 Medium