John C Hoell, DDS
1 Greenfield Dr Somersworth, NH 03878
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 | $82 | 0% | $82 | Medium |
| Sealant placed on the tooth surface to prevent decay | $68 | 0% | $68 | Medium |
| Topical fluoride varnish application | $42 | 0% | $42 | Medium |
Diagnostic Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Comprehensive Dental Exam | $103 | 0% | $103 | Medium |
| Periodic dental exam - established patient | $59 | 0% | $59 | Medium |
| Problem focused evaluation limited to a specific oral health problem or complaint | $88 | 0% | $88 | Medium |
| X-Ray Dental - Complete intraoral series | $159 | 0% | $159 | Medium |
| X-Ray Dental - Four images - bitewings | $79 | 0% | $79 | Medium |
| X-Ray Dental - Intraoral - periapical radiographic image | $36 | 0% | $36 | Medium |
| X-Ray Dental - Two images - bitewings | $55 | 0% | $55 | Medium |
| X-Ray Dental - Additional image of tooth from crown to root, from inside mouth | $30 | 0% | $30 | 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 | $218 | 0% | $218 | Medium |
| Silver (Amalgam) Dental Filling - Two surfaces, primary or permanent | $278 | 0% | $278 | Medium |
| Silver (Amalgam) Dental Filling - Three surfaces, primary or permanent | $341 | 0% | $341 | Medium |
| White (Resin) Dental Filling - One surface, posterior | $218 | 0% | $218 | Medium |
| White (Resin) Dental Filling - Two surfaces, posterior | $278 | 0% | $278 | Medium |
| White (Resin) Dental Filling - One surface, anterior | $205 | 0% | $205 | Medium |
| White (Resin) Dental Filling - Three surfaces, posterior | $341 | 0% | $341 | Medium |
| White (Resin) Dental Filling - Two surfaces, anterior | $249 | 0% | $249 | Medium |
Other Dental Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Maintenance Therapy - Periodontal | $168 | 0% | $168 | Medium |
| Tooth Extraction (Elevation and/or forceps removal) | $431 | 0% | $431 | Medium |