James Borbotsina, DDS

1361 Elm Street, Suite 202 Manchester, NH 03101
Dental Procedures
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My Health Insurance:

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ProcedureEstimate of Total Cost Uninsured Discount What You Will Pay Typical Patient Complexity
Dental Cleaning - Adult$1160%$116 Medium
Dental Cleaning - Child$820%$82 Medium
Dental Exam - Comprehensive$890%$89 Medium
Dental Exam - Periodic, Established Patient$560%$56 Medium
Dental Filling - Silver (Amalgam): One Surface, Primary or Permanent$1840%$184 Medium
Dental Filling - Silver (Amalgam): Three Surfaces, Primary or Permanent$3650%$365 Medium
Dental Filling - Silver (Amalgam): Two Surfaces, Primary or Permanent$2940%$294 Medium
Dental Filling - White (Resin): One Surface, Anterior$1600%$160 Medium
Dental Filling - White (Resin): One Surface, Posterior$2210%$221 Medium
Dental Filling - White (Resin): Three Surfaces, Posterior$3650%$365 Medium
Dental Filling - White (Resin): Two Surfaces, Anterior$2390%$239 Medium
Dental Filling - White (Resin): Two Surfaces, Posterior$2940%$294 Medium
Fluoride - Topical Application$420%$42 Medium
Maintenance Therapy - Periodontal$1730%$173 Medium
Problem Focused Evaluation - Limited to a Specific Oral Health Problem or Complaint$860%$86 Medium
Sealant - Placed on Tooth Surface to Prevent Decay$560%$56 Medium
X-Ray - Additional Image of Tooth from Crown to Root from Inside Mouth$390%$39 Medium
X-Ray - Complete Intraoral Series$2230%$223 Medium
X-Ray - Four Images, Bitewings$760%$76 Medium
X-Ray - Intraoral, Periapical Radiographic Image$330%$33 Medium
X-Ray - Two Images, Bitewings$580%$58 Medium
X-Ray - Whole Mouth from Outside Mouth$1470%$147 Medium