Gregory M Villa, DDS
12 Hospital Drive York, ME 03909
Dental Procedures
Preventive Care
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Adult Dental Cleaning | $97 | 0% | $97 | Medium |
| Child Dental Cleaning | $68 | 0% | $68 | Medium |
| Sealant placed on the tooth surface to prevent decay | $63 | 0% | $63 | Medium |
| Topical fluoride varnish application | $47 | 0% | $47 | Medium |
Diagnostic Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Comprehensive Dental Exam | $89 | 0% | $89 | Medium |
| Periodic dental exam - established patient | $48 | 0% | $48 | Medium |
| Problem focused evaluation limited to a specific oral health problem or complaint | $74 | 0% | $74 | Medium |
| X-Ray Dental - Complete intraoral series | $137 | 0% | $137 | Medium |
| X-Ray Dental - Four images - bitewings | $74 | 0% | $74 | Medium |
| X-Ray Dental - Intraoral - periapical radiographic image | $28 | 0% | $28 | Medium |
| X-Ray Dental - Two images - bitewings | $53 | 0% | $53 | Medium |
| X-Ray Dental - Additional image of tooth from crown to root, from inside mouth | $22 | 0% | $22 | Medium |
Dental Fillings
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Silver (Amalgam) Dental Filling - Two surfaces, primary or permanent | $378 | 0% | $378 | Medium |
| White (Resin) Dental Filling - One surface, posterior | $173 | 0% | $173 | Medium |
| White (Resin) Dental Filling - Two surfaces, posterior | $194 | 0% | $194 | Medium |
| White (Resin) Dental Filling - One surface, anterior | $147 | 0% | $147 | Medium |
| White (Resin) Dental Filling - Two surfaces, anterior | $173 | 0% | $173 | Medium |