Jana T Beati, DMD
356 Mammoth Road Londonderry, NH 03053
Dental Procedures
Preventive Care
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Adult Dental Cleaning | $107 | 0% | $107 | Medium |
| Child Dental Cleaning | $79 | 0% | $79 | Medium |
| Fluoride - Topical Application | $39 | 0% | $39 | Medium |
| Plaque and tartar removal from around teeth and gums-per quadrant | $273 | 0% | $273 | Medium |
| Sealant placed on the tooth surface to prevent decay | $58 | 0% | $58 | Medium |
Diagnostic Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Comprehensive Dental Exam | $100 | 0% | $100 | Medium |
| Periodic dental exam - established patient | $53 | 0% | $53 | Medium |
| Problem focused evaluation limited to a specific oral health problem or complaint | $79 | 0% | $79 | Medium |
| X-Ray Dental - Complete intraoral series | $146 | 0% | $146 | Medium |
| X-Ray Dental - Four images - bitewings | $79 | 0% | $79 | Medium |
| X-Ray Dental - Intraoral - periapical radiographic image | $42 | 0% | $42 | Medium |
| X-Ray Dental - Two images - bitewings | $56 | 0% | $56 | Medium |
| X-Ray Dental - Additional image of tooth from crown to root, from inside mouth | $38 | 0% | $38 | Medium |
| X-Ray Dental - Whole mouth, from outside mouth | $142 | 0% | $142 | 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 | $194 | 0% | $194 | Medium |
| Silver (Amalgam) Dental Filling - Two surfaces, primary or permanent | $231 | 0% | $231 | Medium |
| Silver (Amalgam) Dental Filling - Three surfaces, primary or permanent | $315 | 0% | $315 | Medium |
| White (Resin) Dental Filling - One surface, posterior | $194 | 0% | $194 | Medium |
| White (Resin) Dental Filling - Two surfaces, posterior | $231 | 0% | $231 | Medium |
| White (Resin) Dental Filling - One surface, anterior | $173 | 0% | $173 | Medium |
| White (Resin) Dental Filling - Three surfaces, posterior | $315 | 0% | $315 | Medium |
| White (Resin) Dental Filling - Two surfaces, anterior | $210 | 0% | $210 | Medium |
Orthodontic Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Orthodontic Treatment Visit (Periodic - as part of a contract) | $51 | 0% | $51 | 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 |