Hana Dental Supply
61 Amherst Street Nashua, NH 03064
Dental Procedures
Preventive Care
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Adult Dental Cleaning | $121 | 0% | $121 | Medium |
| Child Dental Cleaning | $121 | 0% | $121 | Medium |
| Plaque and tartar removal from around teeth and gums-per quadrant | $263 | 0% | $263 | Medium |
| Topical fluoride varnish application | $63 | 0% | $63 | Medium |
Diagnostic Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Comprehensive Dental Exam | $95 | 0% | $95 | Medium |
| Periodic dental exam - established patient | $58 | 0% | $58 | Medium |
| Problem focused evaluation limited to a specific oral health problem or complaint | $95 | 0% | $95 | Medium |
| X-Ray Dental - Complete intraoral series | $221 | 0% | $221 | Medium |
| X-Ray Dental - Four images - bitewings | $84 | 0% | $84 | Medium |
| X-Ray Dental - Intraoral - periapical radiographic image | $42 | 0% | $42 | Medium |
| X-Ray Dental - Two images - bitewings | $63 | 0% | $63 | Medium |
| X-Ray Dental - Additional image of tooth from crown to root, from inside mouth | $37 | 0% | $37 | Medium |
| X-Ray Dental - Whole mouth, from outside mouth | $158 | 0% | $158 | Medium |
Dental Fillings
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Silver (Amalgam) Dental Filling - One surface, primary or permanent | $189 | 0% | $189 | Medium |
| Silver (Amalgam) Dental Filling - Two surfaces, primary or permanent | $242 | 0% | $242 | Medium |
| Silver (Amalgam) Dental Filling - Three surfaces, primary or permanent | $284 | 0% | $284 | Medium |
| White (Resin) Dental Filling - One surface, posterior | $189 | 0% | $189 | Medium |
| White (Resin) Dental Filling - Two surfaces, posterior | $242 | 0% | $242 | Medium |
| White (Resin) Dental Filling - Two surfaces, anterior | $210 | 0% | $210 | Medium |
Other Dental Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Tooth Extraction (Elevation and/or forceps removal) | $189 | 0% | $189 | Medium |