Hanover Street Family Dental

861 Hanover Street Manchester, NH 03104
Dental Procedures
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ProcedureEstimate of Total Cost Uninsured Discount What You Will Pay
Dental Cleaning - Adult$1100%$110
Dental Cleaning - Child$1100%$110
Dental Exam - Comprehensive$1050%$105
Dental Exam - Periodic, Established Patient$610%$61
Dental Filling - Silver (Amalgam): One Surface, Primary or Permanent$2080%$208
Dental Filling - Silver (Amalgam): Three Surfaces, Primary or Permanent$3260%$326
Dental Filling - Silver (Amalgam): Two Surfaces, Primary or Permanent$2650%$265
Dental Filling - White (Resin): One Surface, Anterior$2120%$212
Dental Filling - White (Resin): One Surface, Posterior$2190%$219
Dental Filling - White (Resin): Three Surfaces, Posterior$3430%$343
Dental Filling - White (Resin): Two Surfaces, Anterior$2710%$271
Dental Filling - White (Resin): Two Surfaces, Posterior$3210%$321
Flouride - Topical Varnish Application$560%$56
Fluoride - Topical Application$510%$51
Maintenance Therapy - Periodontal$1460%$146
Orthodontic Treatment - Periodic Visit, Part of a Contract$990%$99
Plaque and Tartar Removal - Around Teeth and Gums, Per Quadrant$2510%$251
Problem Focused Evaluation - Limited to a Specific Oral Health Problem or Complaint$890%$89
Root Canal - Anterior Tooth$8870%$887
Root Canal - Bicuspid Tooth$9400%$940
Root Canal - Molar$1,0450%$1,045
Sealant - Placed on Tooth Surface to Prevent Decay$710%$71
Tooth Extraction - Elevation and/or Forceps Removal$1680%$168
X-Ray - Additional Image of Tooth from Crown to Root from Inside Mouth$250%$25
X-Ray - Complete Intraoral Series$1600%$160
X-Ray - Four Images, Bitewings$800%$80
X-Ray - Intraoral, Periapical Radiographic Image$360%$36
X-Ray - Two Images, Bitewings$760%$76
X-Ray - Whole Mouth from Outside Mouth$1350%$135