John A Nieskens, DDS
60 Hancock Road Peterborough, NH 03458
Dental Procedures
| Procedure | Estimate of Total Cost | Uninsured Discount | What You Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Dental Cleaning - Adult | $202 | 0% | $202 | Medium |
| Dental Cleaning - Child | $149 | 0% | $149 | Medium |
| Dental Exam - Periodic, Established Patient | $84 | 0% | $84 | Medium |
| Dental Filling - White (Resin): One Surface, Posterior | $256 | 0% | $256 | Medium |
| Dental Filling - White (Resin): Three Surfaces, Posterior | $521 | 0% | $521 | Medium |
| Dental Filling - White (Resin): Two Surfaces, Posterior | $433 | 0% | $433 | Medium |
| Fluoride - Topical Application | $53 | 0% | $53 | Medium |
| Problem Focused Evaluation - Limited to a Specific Oral Health Problem or Complaint | $84 | 0% | $84 | Medium |
| Sealant - Placed on Tooth Surface to Prevent Decay | $101 | 0% | $101 | Medium |
| X-Ray - Four Images, Bitewings | $139 | 0% | $139 | Medium |
| X-Ray - Intraoral, Periapical Radiographic Image | $29 | 0% | $29 | Medium |
| X-Ray - Two Images, Bitewings | $92 | 0% | $92 | Medium |
