Exceptional Dentistry

1 Stiles Road, Suite 102 Salem, NH 03079
Dental Procedures
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ProcedureEstimate of Total Cost Uninsured Discount What You Will Pay Typical Patient Complexity
Dental Cleaning - Adult$1210%$121 Medium
Dental Cleaning - Child$1210%$121 Medium
Dental Exam - Comprehensive$1000%$100 Medium
Dental Exam - Periodic, Established Patient$580%$58 Medium
Dental Filling - Silver (Amalgam): One Surface, Primary or Permanent$2120%$212 Medium
Dental Filling - Silver (Amalgam): Three Surfaces, Primary or Permanent$3180%$318 Medium
Dental Filling - Silver (Amalgam): Two Surfaces, Primary or Permanent$2770%$277 Medium
Dental Filling - White (Resin): One Surface, Anterior$1920%$192 Medium
Dental Filling - White (Resin): One Surface, Posterior$2120%$212 Medium
Dental Filling - White (Resin): Three Surfaces, Posterior$3180%$318 Medium
Dental Filling - White (Resin): Two Surfaces, Anterior$2170%$217 Medium
Dental Filling - White (Resin): Two Surfaces, Posterior$2770%$277 Medium
Flouride - Topical Varnish Application$640%$64 Medium
Maintenance Therapy - Periodontal$1810%$181 Medium
Orthodontic Treatment - Periodic Visit, Part of a Contract$680%$68 Medium
Plaque and Tartar Removal - Around Teeth and Gums, Per Quadrant$2820%$282 Medium
Problem Focused Evaluation - Limited to a Specific Oral Health Problem or Complaint$960%$96 Medium
Root Canal - Anterior Tooth$9860%$986 Medium
Root Canal - Bicuspid Tooth$1,1770%$1,177 Medium
Root Canal - Molar$1,4910%$1,491 Medium
Tooth Extraction - Elevation and/or Forceps Removal$2130%$213 Medium
X-Ray - Additional Image of Tooth from Crown to Root from Inside Mouth$330%$33 Medium
X-Ray - Complete Intraoral Series$1980%$198 Medium
X-Ray - Four Images, Bitewings$770%$77 Medium
X-Ray - Intraoral, Periapical Radiographic Image$380%$38 Medium
X-Ray - Whole Mouth from Outside Mouth$1460%$146 Medium