Herzog Aesthetic Family Dental Care
Dental Procedures
| Procedure | Estimate of Total Cost | Uninsured Discount | What You Will Pay |
|---|---|---|---|
| Dental Cleaning - Adult | $123 | 0% | $123 |
| Dental Cleaning - Child | $93 | 0% | $93 |
| Dental Exam - Comprehensive | $152 | 0% | $152 |
| Dental Exam - Periodic, Established Patient | $70 | 0% | $70 |
| Dental Filling - White (Resin): One Surface, Posterior | $228 | 0% | $228 |
| Dental Filling - White (Resin): Three Surfaces, Posterior | $372 | 0% | $372 |
| Dental Filling - White (Resin): Two Surfaces, Posterior | $315 | 0% | $315 |
| Flouride - Topical Varnish Application | $61 | 0% | $61 |
| Maintenance Therapy - Periodontal | $179 | 0% | $179 |
| Plaque and Tartar Removal - Around Teeth and Gums, Per Quadrant | $402 | 0% | $402 |
| Problem Focused Evaluation - Limited to a Specific Oral Health Problem or Complaint | $174 | 0% | $174 |
| Root Canal - Molar | $1,680 | 0% | $1,680 |
| X-Ray - Four Images, Bitewings | $82 | 0% | $82 |
| X-Ray - Intraoral, Periapical Radiographic Image | $71 | 0% | $71 |
| X-Ray - Two Images, Bitewings | $82 | 0% | $82 |
| X-Ray - Whole Mouth from Outside Mouth | $226 | 0% | $226 |