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
Dental Cleaning - Adult$1180%$118
Dental Cleaning - Child$820%$82
Dental Exam - Comprehensive$1030%$103
Dental Exam - Periodic, Established Patient$590%$59
Dental Filling - Silver (Amalgam): One Surface, Primary or Permanent$2030%$203
Dental Filling - Silver (Amalgam): Three Surfaces, Primary or Permanent$3170%$317
Dental Filling - Silver (Amalgam): Two Surfaces, Primary or Permanent$2630%$263
Dental Filling - White (Resin): One Surface, Anterior$1830%$183
Dental Filling - White (Resin): One Surface, Posterior$2130%$213
Dental Filling - White (Resin): Three Surfaces, Posterior$3480%$348
Dental Filling - White (Resin): Two Surfaces, Anterior$2330%$233
Dental Filling - White (Resin): Two Surfaces, Posterior$2790%$279
Flouride - Topical Varnish Application$380%$38
Fluoride - Topical Application$440%$44
Maintenance Therapy - Periodontal$1770%$177
Plaque and Tartar Removal - Around Teeth and Gums, Per Quadrant$2890%$289
Problem Focused Evaluation - Limited to a Specific Oral Health Problem or Complaint$980%$98
Root Canal - Anterior Tooth$9960%$996
Root Canal - Bicuspid Tooth$1,2210%$1,221
Sealant - Placed on Tooth Surface to Prevent Decay$640%$64
Tooth Extraction - Elevation and/or Forceps Removal$2500%$250
X-Ray - Additional Image of Tooth from Crown to Root from Inside Mouth$330%$33
X-Ray - Complete Intraoral Series$1810%$181
X-Ray - Four Images, Bitewings$800%$80
X-Ray - Intraoral, Periapical Radiographic Image$360%$36
X-Ray - Two Images, Bitewings$570%$57
X-Ray - Whole Mouth from Outside Mouth$1520%$152