First Street Smiles
7 1st Street North Andover, MA 01845
Dental Procedures
Preventive Care
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Adult Dental Cleaning | $131 | 0% | $131 | Medium |
| Child Dental Cleaning | $95 | 0% | $95 | Medium |
Diagnostic Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Comprehensive Dental Exam | $131 | 0% | $131 | Medium |
| Periodic dental exam - established patient | $68 | 0% | $68 | Medium |
| Problem focused evaluation limited to a specific oral health problem or complaint | $100 | 0% | $100 | Medium |
| X-Ray Dental - Complete intraoral series | $205 | 0% | $205 | Medium |
| X-Ray Dental - Four images - bitewings | $110 | 0% | $110 | Medium |
| X-Ray Dental - Intraoral - periapical radiographic image | $37 | 0% | $37 | 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 | $37 | 0% | $37 | 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 | $263 | 0% | $263 | Medium |
| Silver (Amalgam) Dental Filling - Two surfaces, primary or permanent | $315 | 0% | $315 | Medium |
| White (Resin) Dental Filling - One surface, posterior | $263 | 0% | $263 | Medium |
| White (Resin) Dental Filling - Two surfaces, posterior | $315 | 0% | $315 | Medium |
| White (Resin) Dental Filling - One surface, anterior | $263 | 0% | $263 | Medium |
| White (Resin) Dental Filling - Three surfaces, posterior | $394 | 0% | $394 | Medium |
| White (Resin) Dental Filling - Two surfaces, anterior | $315 | 0% | $315 | Medium |