Grace Family Dentistry

143 Airport Concord, NH 03301
Dental Procedures
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ProcedureEstimate of Total Cost Uninsured Discount What You Will Pay
Dental Cleaning - Adult$1070%$107
Dental Cleaning - Child$970%$97
Dental Exam - Comprehensive$1020%$102
Dental Exam - Periodic, Established Patient$500%$50
Dental Filling - Silver (Amalgam): One Surface, Primary or Permanent$1890%$189
Dental Filling - Silver (Amalgam): Three Surfaces, Primary or Permanent$3420%$342
Dental Filling - Silver (Amalgam): Two Surfaces, Primary or Permanent$2630%$263
Dental Filling - White (Resin): One Surface, Anterior$1670%$167
Dental Filling - White (Resin): One Surface, Posterior$1890%$189
Dental Filling - White (Resin): Three Surfaces, Posterior$3420%$342
Dental Filling - White (Resin): Two Surfaces, Anterior$2050%$205
Dental Filling - White (Resin): Two Surfaces, Posterior$2630%$263
Flouride - Topical Varnish Application$570%$57
Fluoride - Topical Application$510%$51
Maintenance Therapy - Periodontal$1530%$153
Orthodontic Treatment - Periodic Visit, Part of a Contract$1580%$158
Plaque and Tartar Removal - Around Teeth and Gums, Per Quadrant$2760%$276
Problem Focused Evaluation - Limited to a Specific Oral Health Problem or Complaint$890%$89
Sealant - Placed on Tooth Surface to Prevent Decay$700%$70
Tooth Extraction - Elevation and/or Forceps Removal$2140%$214
X-Ray - Additional Image of Tooth from Crown to Root from Inside Mouth$300%$30
X-Ray - Complete Intraoral Series$2010%$201
X-Ray - Four Images, Bitewings$720%$72
X-Ray - Intraoral, Periapical Radiographic Image$380%$38
X-Ray - Two Images, Bitewings$590%$59
X-Ray - Whole Mouth from Outside Mouth$1310%$131