Goodwin Community Health

311 NH-108 Somersworth, NH 03878
Dental Procedures
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ProcedureEstimate of Total Cost Uninsured Discount What You Will Pay Typical Patient Complexity
Dental Cleaning - Adult$1010%$101 Medium
Dental Cleaning - Child$800%$80 Medium
Dental Exam - Comprehensive$950%$95 Medium
Dental Exam - Periodic, Established Patient$540%$54 Medium
Dental Filling - Silver (Amalgam): One Surface, Primary or Permanent$1920%$192 Medium
Dental Filling - Silver (Amalgam): Three Surfaces, Primary or Permanent$2340%$234 Medium
Dental Filling - Silver (Amalgam): Two Surfaces, Primary or Permanent$1900%$190 Medium
Dental Filling - White (Resin): One Surface, Anterior$1730%$173 Medium
Dental Filling - White (Resin): One Surface, Posterior$2130%$213 Medium
Dental Filling - White (Resin): Three Surfaces, Posterior$3080%$308 Medium
Dental Filling - White (Resin): Two Surfaces, Anterior$2130%$213 Medium
Dental Filling - White (Resin): Two Surfaces, Posterior$2680%$268 Medium
Flouride - Topical Varnish Application$380%$38 Medium
Fluoride - Topical Application$400%$40 Medium
Maintenance Therapy - Periodontal$1690%$169 Medium
Plaque and Tartar Removal - Around Teeth and Gums, Per Quadrant$2730%$273 Medium
Problem Focused Evaluation - Limited to a Specific Oral Health Problem or Complaint$810%$81 Medium
Root Canal - Anterior Tooth$7690%$769 Medium
Root Canal - Bicuspid Tooth$1,5410%$1,541 Medium
Sealant - Placed on Tooth Surface to Prevent Decay$590%$59 Medium
Tooth Extraction - Elevation and/or Forceps Removal$1840%$184 Medium
X-Ray - Additional Image of Tooth from Crown to Root from Inside Mouth$260%$26 Medium
X-Ray - Complete Intraoral Series$1380%$138 Medium
X-Ray - Four Images, Bitewings$800%$80 Medium
X-Ray - Intraoral, Periapical Radiographic Image$290%$29 Medium
X-Ray - Two Images, Bitewings$470%$47 Medium
X-Ray - Whole Mouth from Outside Mouth$1520%$152 Medium