Frank J Benenati, DDS
50 John Streetark Hwy Newport, NH 03773
Dental Procedures
Preventive Care
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Adult Dental Cleaning | $95 | 0% | $95 | Medium |
| Child Dental Cleaning | $74 | 0% | $74 | Medium |
| Fluoride - Topical Application | $42 | 0% | $42 | Medium |
| Plaque and tartar removal from around teeth and gums-per quadrant | $252 | 0% | $252 | Medium |
| Sealant placed on the tooth surface to prevent decay | $53 | 0% | $53 | Medium |
| Topical fluoride varnish application | $41 | 0% | $41 | Medium |
Diagnostic Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Comprehensive Dental Exam | $89 | 0% | $89 | Medium |
| Periodic dental exam - established patient | $43 | 0% | $43 | Medium |
| Problem focused evaluation limited to a specific oral health problem or complaint | $79 | 0% | $79 | Medium |
| X-Ray Dental - Complete intraoral series | $133 | 0% | $133 | Medium |
| X-Ray Dental - Four images - bitewings | $63 | 0% | $63 | Medium |
| X-Ray Dental - Intraoral - periapical radiographic image | $30 | 0% | $30 | Medium |
| X-Ray Dental - Two images - bitewings | $46 | 0% | $46 | Medium |
| X-Ray Dental - Additional image of tooth from crown to root, from inside mouth | $25 | 0% | $25 | 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 | $168 | 0% | $168 | Medium |
| Silver (Amalgam) Dental Filling - Two surfaces, primary or permanent | $228 | 0% | $228 | Medium |
| Silver (Amalgam) Dental Filling - Three surfaces, primary or permanent | $210 | 0% | $210 | Medium |
| White (Resin) Dental Filling - One surface, posterior | $168 | 0% | $168 | Medium |
| White (Resin) Dental Filling - Two surfaces, posterior | $228 | 0% | $228 | Medium |
| White (Resin) Dental Filling - One surface, anterior | $147 | 0% | $147 | Medium |
| White (Resin) Dental Filling - Three surfaces, posterior | $286 | 0% | $286 | Medium |
| White (Resin) Dental Filling - Two surfaces, anterior | $184 | 0% | $184 | Medium |
Other Dental Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Maintenance Therapy - Periodontal | $128 | 0% | $128 | Medium |
| Tooth Extraction (Elevation and/or forceps removal) | $178 | 0% | $178 | Medium |