Hanover Street Family Dental

861 Hanover Street Manchester, NH 03104
Dental Procedures
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ProcedureEstimate of Total Cost Number of Visits What You Will Pay Uninsured Discount: 0%
Dental Cleaning - Adult$110N/A$110
Dental Cleaning - Child$100N/A$100
Dental Exam - Comprehensive$105N/A$105
Dental Exam - Periodic, Established Patient$61N/A$61
Dental Filling - Silver (Amalgam): One Surface, Primary or Permanent$208N/A$208
Dental Filling - Silver (Amalgam): Three Surfaces, Primary or Permanent$343N/A$343
Dental Filling - Silver (Amalgam): Two Surfaces, Primary or Permanent$279N/A$279
Dental Filling - White (Resin): One Surface, Anterior$212N/A$212
Dental Filling - White (Resin): One Surface, Posterior$219N/A$219
Dental Filling - White (Resin): Three Surfaces, Posterior$343N/A$343
Dental Filling - White (Resin): Two Surfaces, Anterior$271N/A$271
Dental Filling - White (Resin): Two Surfaces, Posterior$321N/A$321
Flouride - Topical Varnish Application$56N/A$56
Fluoride - Topical Application$51N/A$51
Maintenance Therapy - Periodontal$164N/A$164
Oral Hygiene Instructions$66N/A$66
Orthodontic Treatment - Periodic Visit, Part of a Contract$99N/A$99
Plaque and Tartar Removal - Around Teeth and Gums, Per Quadrant$263N/A$263
Problem Focused Evaluation - Limited to a Specific Oral Health Problem or Complaint$89N/A$89
Root Canal - Anterior Tooth$940N/A$940
Root Canal - Bicuspid Tooth$1,150N/A$1,150
Root Canal - Molar$1,259N/A$1,259
Sealant - Placed on Tooth Surface to Prevent Decay$71N/A$71
Tooth Extraction - Elevation and/or Forceps Removal$154N/A$154
X-Ray - Additional Image of Tooth from Crown to Root from Inside Mouth$30N/A$30
X-Ray - Complete Intraoral Series$160N/A$160
X-Ray - Four Images, Bitewings$80N/A$80
X-Ray - Intraoral, Periapical Radiographic Image$36N/A$36
X-Ray - Two Images, Bitewings$66N/A$66
X-Ray - Whole Mouth from Outside Mouth$135N/A$135