Family Dental Care of Milford
154 Elm Street Milford, NH 03055
Dental Procedures
Preventive Care
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Adult Dental Cleaning | $111 | 0% | $111 | Medium |
| Child Dental Cleaning | $85 | 0% | $85 | Medium |
| Fluoride - Topical Application | $53 | 0% | $53 | Medium |
| Plaque and tartar removal from around teeth and gums-per quadrant | $289 | 0% | $289 | Medium |
| Sealant placed on the tooth surface to prevent decay | $65 | 0% | $65 | Medium |
| Topical fluoride varnish application | $53 | 0% | $53 | Medium |
Diagnostic Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Comprehensive Dental Exam | $105 | 0% | $105 | Medium |
| Periodic dental exam - established patient | $61 | 0% | $61 | Medium |
| Problem focused evaluation limited to a specific oral health problem or complaint | $96 | 0% | $96 | Medium |
| X-Ray Dental - Complete intraoral series | $209 | 0% | $209 | Medium |
| X-Ray Dental - Four images - bitewings | $79 | 0% | $79 | Medium |
| X-Ray Dental - Intraoral - periapical radiographic image | $35 | 0% | $35 | Medium |
| X-Ray Dental - Two images - bitewings | $58 | 0% | $58 | Medium |
| X-Ray Dental - Additional image of tooth from crown to root, from inside mouth | $34 | 0% | $34 | Medium |
| X-Ray Dental - Whole mouth, from outside mouth | $145 | 0% | $145 | 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 | $209 | 0% | $209 | Medium |
| Silver (Amalgam) Dental Filling - Two surfaces, primary or permanent | $271 | 0% | $271 | Medium |
| Silver (Amalgam) Dental Filling - Three surfaces, primary or permanent | $350 | 0% | $350 | Medium |
| White (Resin) Dental Filling - One surface, posterior | $209 | 0% | $209 | Medium |
| White (Resin) Dental Filling - Two surfaces, posterior | $271 | 0% | $271 | Medium |
| White (Resin) Dental Filling - One surface, anterior | $193 | 0% | $193 | Medium |
| White (Resin) Dental Filling - Three surfaces, posterior | $350 | 0% | $350 | Medium |
| White (Resin) Dental Filling - Two surfaces, anterior | $235 | 0% | $235 | 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) | $121 | 0% | $121 | Medium |
Other Dental Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Maintenance Therapy - Periodontal | $168 | 0% | $168 | Medium |
| Tooth Extraction (Elevation and/or forceps removal) | $181 | 0% | $181 | Medium |