Harvey Weener, DDS
283 Broad Street Nashua, NH 03060
Dental Procedures
Preventive Care
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Adult Dental Cleaning | $126 | 0% | $126 | Medium |
| Child Dental Cleaning | $106 | 0% | $106 | Medium |
| Fluoride - Topical Application | $44 | 0% | $44 | Medium |
| Plaque and tartar removal from around teeth and gums-per quadrant | $295 | 0% | $295 | Medium |
| Sealant placed on the tooth surface to prevent decay | $67 | 0% | $67 | Medium |
| Topical fluoride varnish application | $43 | 0% | $43 | Medium |
Diagnostic Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Comprehensive Dental Exam | $99 | 0% | $99 | Medium |
| Periodic dental exam - established patient | $59 | 0% | $59 | Medium |
| Problem focused evaluation limited to a specific oral health problem or complaint | $99 | 0% | $99 | Medium |
| X-Ray Dental - Complete intraoral series | $177 | 0% | $177 | Medium |
| X-Ray Dental - Four images - bitewings | $79 | 0% | $79 | Medium |
| X-Ray Dental - Intraoral - periapical radiographic image | $43 | 0% | $43 | Medium |
| X-Ray Dental - Two images - bitewings | $60 | 0% | $60 | Medium |
| X-Ray Dental - Additional image of tooth from crown to root, from inside mouth | $41 | 0% | $41 | Medium |
| X-Ray Dental - Whole mouth, from outside mouth | $154 | 0% | $154 | 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 | $234 | 0% | $234 | Medium |
| Silver (Amalgam) Dental Filling - Two surfaces, primary or permanent | $301 | 0% | $301 | Medium |
| Silver (Amalgam) Dental Filling - Three surfaces, primary or permanent | $361 | 0% | $361 | Medium |
| White (Resin) Dental Filling - One surface, posterior | $234 | 0% | $234 | Medium |
| White (Resin) Dental Filling - Two surfaces, posterior | $301 | 0% | $301 | Medium |
| White (Resin) Dental Filling - One surface, anterior | $209 | 0% | $209 | Medium |
| White (Resin) Dental Filling - Three surfaces, posterior | $361 | 0% | $361 | Medium |
| White (Resin) Dental Filling - Two surfaces, anterior | $263 | 0% | $263 | Medium |
Other Dental Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Maintenance Therapy - Periodontal | $168 | 0% | $168 | Medium |
| Tooth Extraction (Elevation and/or forceps removal) | $218 | 0% | $218 | Medium |