Grace Family Dentistry

143 Airport Concord, NH 03301
Dental Procedures
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ProcedureEstimate of Total Cost Uninsured Discount What You Will Pay Typical Patient Complexity
Dental Cleaning - Adult$1050%$105 Medium
Dental Cleaning - Child$1010%$101 Medium
Dental Exam - Comprehensive$900%$90 Medium
Dental Exam - Periodic, Established Patient$490%$49 Medium
Dental Filling - Silver (Amalgam): One Surface, Primary or Permanent$1890%$189 Medium
Dental Filling - Silver (Amalgam): Three Surfaces, Primary or Permanent$3400%$340 Medium
Dental Filling - Silver (Amalgam): Two Surfaces, Primary or Permanent$2610%$261 Medium
Dental Filling - White (Resin): One Surface, Anterior$1650%$165 Medium
Dental Filling - White (Resin): One Surface, Posterior$1890%$189 Medium
Dental Filling - White (Resin): Three Surfaces, Posterior$3420%$342 Medium
Dental Filling - White (Resin): Two Surfaces, Anterior$2020%$202 Medium
Dental Filling - White (Resin): Two Surfaces, Posterior$2630%$263 Medium
Flouride - Topical Varnish Application$550%$55 Medium
Fluoride - Topical Application$510%$51 Medium
Maintenance Therapy - Periodontal$1510%$151 Medium
Plaque and Tartar Removal - Around Teeth and Gums, Per Quadrant$2760%$276 Medium
Problem Focused Evaluation - Limited to a Specific Oral Health Problem or Complaint$880%$88 Medium
Root Canal - Anterior Tooth$8520%$852 Medium
Sealant - Placed on Tooth Surface to Prevent Decay$700%$70 Medium
Tooth Extraction - Elevation and/or Forceps Removal$2090%$209 Medium
X-Ray - Additional Image of Tooth from Crown to Root from Inside Mouth$270%$27 Medium
X-Ray - Complete Intraoral Series$2000%$200 Medium
X-Ray - Four Images, Bitewings$710%$71 Medium
X-Ray - Intraoral, Periapical Radiographic Image$340%$34 Medium
X-Ray - Two Images, Bitewings$620%$62 Medium
X-Ray - Whole Mouth from Outside Mouth$1290%$129 Medium