Hathorne Family Dental
Dental Procedures
| Procedure | Estimate of Total Cost | Number of Visits | What You Will Pay Uninsured Discount: 0% |
|---|---|---|---|
| Dental Cleaning - Adult | $120 | N/A | $120 |
| Dental Cleaning - Child | $87 | N/A | $87 |
| Dental Exam - Comprehensive | $142 | N/A | $142 |
| Dental Exam - Periodic, Established Patient | $51 | N/A | $51 |
| Dental Filling - Silver (Amalgam): Three Surfaces, Primary or Permanent | $327 | N/A | $327 |
| Dental Filling - White (Resin): One Surface, Anterior | $173 | N/A | $173 |
| Dental Filling - White (Resin): One Surface, Posterior | $209 | N/A | $209 |
| Dental Filling - White (Resin): Three Surfaces, Posterior | $327 | N/A | $327 |
| Dental Filling - White (Resin): Two Surfaces, Anterior | $424 | N/A | $424 |
| Dental Filling - White (Resin): Two Surfaces, Posterior | $540 | N/A | $540 |
| Flouride - Topical Varnish Application | $54 | N/A | $54 |
| Problem Focused Evaluation - Limited to a Specific Oral Health Problem or Complaint | $95 | N/A | $95 |
| X-Ray - Four Images, Bitewings | $86 | N/A | $86 |
| X-Ray - Intraoral, Periapical Radiographic Image | $37 | N/A | $37 |
| X-Ray - Whole Mouth from Outside Mouth | $222 | N/A | $222 |