Haverhill Dental Associates
370 Main Street Haverhill, MA 01830
Dental Procedures
Preventive Care
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Adult Dental Cleaning | $109 | 0% | $109 | Medium |
| Child Dental Cleaning | $101 | 0% | $101 | Medium |
| Plaque and tartar removal from around teeth and gums-per quadrant | $345 | 0% | $345 | Medium |
| Sealant placed on the tooth surface to prevent decay | $67 | 0% | $67 | Medium |
| Topical fluoride varnish application | $53 | 0% | $53 | Medium |
Diagnostic Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Comprehensive Dental Exam | $76 | 0% | $76 | Medium |
| Periodic dental exam - established patient | $46 | 0% | $46 | Medium |
| Problem focused evaluation limited to a specific oral health problem or complaint | $93 | 0% | $93 | Medium |
| X-Ray Dental - Complete intraoral series | $147 | 0% | $147 | Medium |
| X-Ray Dental - Four images - bitewings | $77 | 0% | $77 | Medium |
| X-Ray Dental - Intraoral - periapical radiographic image | $36 | 0% | $36 | Medium |
| X-Ray Dental - Two images - bitewings | $47 | 0% | $47 | Medium |
| X-Ray Dental - Additional image of tooth from crown to root, from inside mouth | $21 | 0% | $21 | Medium |
| X-Ray Dental - Whole mouth, from outside mouth | $159 | 0% | $159 | 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 | $251 | 0% | $251 | Medium |
| Silver (Amalgam) Dental Filling - Two surfaces, primary or permanent | $227 | 0% | $227 | Medium |
| Silver (Amalgam) Dental Filling - Three surfaces, primary or permanent | $290 | 0% | $290 | Medium |
| White (Resin) Dental Filling - One surface, posterior | $204 | 0% | $204 | Medium |
| White (Resin) Dental Filling - Two surfaces, posterior | $300 | 0% | $300 | Medium |
| White (Resin) Dental Filling - One surface, anterior | $208 | 0% | $208 | Medium |
| White (Resin) Dental Filling - Three surfaces, posterior | $292 | 0% | $292 | Medium |
| White (Resin) Dental Filling - Two surfaces, anterior | $251 | 0% | $251 | Medium |
Other Dental Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Maintenance Therapy - Periodontal | $151 | 0% | $151 | Medium |
| Tooth Extraction (Elevation and/or forceps removal) | $191 | 0% | $191 | Medium |