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 Typical Patient Complexity
Dental Cleaning - Adult$1100%$110 Medium
Dental Cleaning - Child$1200%$120 Medium
Dental Exam - Comprehensive$1050%$105 Medium
Dental Exam - Periodic, Established Patient$610%$61 Medium
Dental Filling - Silver (Amalgam): One Surface, Primary or Permanent$2080%$208 Medium
Dental Filling - Silver (Amalgam): Three Surfaces, Primary or Permanent$3310%$331 Medium
Dental Filling - Silver (Amalgam): Two Surfaces, Primary or Permanent$2650%$265 Medium
Dental Filling - White (Resin): One Surface, Anterior$2040%$204 Medium
Dental Filling - White (Resin): One Surface, Posterior$2190%$219 Medium
Dental Filling - White (Resin): Three Surfaces, Posterior$3910%$391 Medium
Dental Filling - White (Resin): Two Surfaces, Anterior$2590%$259 Medium
Dental Filling - White (Resin): Two Surfaces, Posterior$3210%$321 Medium
Flouride - Topical Varnish Application$560%$56 Medium
Fluoride - Topical Application$510%$51 Medium
Maintenance Therapy - Periodontal$1410%$141 Medium
Plaque and Tartar Removal - Around Teeth and Gums, Per Quadrant$2630%$263 Medium
Problem Focused Evaluation - Limited to a Specific Oral Health Problem or Complaint$890%$89 Medium
Root Canal - Anterior Tooth$1,3230%$1,323 Medium
Root Canal - Bicuspid Tooth$1,0310%$1,031 Medium
Sealant - Placed on Tooth Surface to Prevent Decay$710%$71 Medium
Tooth Extraction - Elevation and/or Forceps Removal$2250%$225 Medium
X-Ray - Additional Image of Tooth from Crown to Root from Inside Mouth$250%$25 Medium
X-Ray - Complete Intraoral Series$1600%$160 Medium
X-Ray - Four Images, Bitewings$800%$80 Medium
X-Ray - Intraoral, Periapical Radiographic Image$360%$36 Medium
X-Ray - Two Images, Bitewings$600%$60 Medium
X-Ray - Whole Mouth from Outside Mouth$1350%$135 Medium