Hampshire Family Dental

61 Route 27 Raymond, NH 03077
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$850%$85 Medium
Dental Exam - Comprehensive$930%$93 Medium
Dental Exam - Periodic, Established Patient$600%$60 Medium
Dental Filling - Silver (Amalgam): One Surface, Primary or Permanent$1910%$191 Medium
Dental Filling - Silver (Amalgam): Three Surfaces, Primary or Permanent$3400%$340 Medium
Dental Filling - Silver (Amalgam): Two Surfaces, Primary or Permanent$2630%$263 Medium
Dental Filling - White (Resin): One Surface, Anterior$1750%$175 Medium
Dental Filling - White (Resin): One Surface, Posterior$1910%$191 Medium
Dental Filling - White (Resin): Three Surfaces, Posterior$3400%$340 Medium
Dental Filling - White (Resin): Two Surfaces, Anterior$2150%$215 Medium
Dental Filling - White (Resin): Two Surfaces, Posterior$2630%$263 Medium
Fluoride - Topical Application$430%$43 Medium
Maintenance Therapy - Periodontal$1530%$153 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
Sealant - Placed on Tooth Surface to Prevent Decay$590%$59 Medium
Tooth Extraction - Elevation and/or Forceps Removal$2870%$287 Medium
X-Ray - Additional Image of Tooth from Crown to Root from Inside Mouth$270%$27 Medium
X-Ray - Complete Intraoral Series$1460%$146 Medium
X-Ray - Four Images, Bitewings$710%$71 Medium
X-Ray - Intraoral, Periapical Radiographic Image$340%$34 Medium
X-Ray - Two Images, Bitewings$500%$50 Medium
X-Ray - Whole Mouth from Outside Mouth$1290%$129 Medium