Franklyn Liberatore, DMD
Dental Procedures
| Procedure | Estimate of Total Cost | Uninsured Discount | What You Will Pay |
|---|---|---|---|
| Dental Cleaning - Adult | $231 | 0% | $231 |
| Dental Cleaning - Child | $179 | 0% | $179 |
| Dental Exam - Comprehensive | $181 | 0% | $181 |
| Dental Exam - Periodic, Established Patient | $101 | 0% | $101 |
| Dental Filling - White (Resin): One Surface, Anterior | $236 | 0% | $236 |
| Dental Filling - White (Resin): Three Surfaces, Posterior | $368 | 0% | $368 |
| Dental Filling - White (Resin): Two Surfaces, Anterior | $289 | 0% | $289 |
| Dental Filling - White (Resin): Two Surfaces, Posterior | $578 | 0% | $578 |
| Flouride - Topical Varnish Application | $74 | 0% | $74 |
| Problem Focused Evaluation - Limited to a Specific Oral Health Problem or Complaint | $95 | 0% | $95 |
| Tooth Extraction - Elevation and/or Forceps Removal | $263 | 0% | $263 |
| X-Ray - Additional Image of Tooth from Crown to Root from Inside Mouth | $32 | 0% | $32 |
| X-Ray - Complete Intraoral Series | $315 | 0% | $315 |
| X-Ray - Four Images, Bitewings | $147 | 0% | $147 |
| X-Ray - Intraoral, Periapical Radiographic Image | $42 | 0% | $42 |