Jonathan Terhune, DMD
58 Franklin Street Franklin, NH 03235
Dental Procedures
Preventive Care
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Adult Dental Cleaning | $95 | 0% | $95 | Medium |
| Child Dental Cleaning | $83 | 0% | $83 | Medium |
| Fluoride - Topical Application | $42 | 0% | $42 | Medium |
| Plaque and tartar removal from around teeth and gums-per quadrant | $263 | 0% | $263 | Medium |
| Sealant placed on the tooth surface to prevent decay | $53 | 0% | $53 | 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 | $95 | 0% | $95 | Medium |
| Periodic dental exam - established patient | $47 | 0% | $47 | Medium |
| Problem focused evaluation limited to a specific oral health problem or complaint | $89 | 0% | $89 | Medium |
| X-Ray Dental - Four images - bitewings | $68 | 0% | $68 | Medium |
| X-Ray Dental - Intraoral - periapical radiographic image | $34 | 0% | $34 | Medium |
| X-Ray Dental - Two images - bitewings | $53 | 0% | $53 | Medium |
| X-Ray Dental - Additional image of tooth from crown to root, from inside mouth | $16 | 0% | $16 | 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 | $145 | 0% | $145 | Medium |
| Silver (Amalgam) Dental Filling - Two surfaces, primary or permanent | $179 | 0% | $179 | Medium |
| Silver (Amalgam) Dental Filling - Three surfaces, primary or permanent | $218 | 0% | $218 | Medium |
| White (Resin) Dental Filling - One surface, posterior | $147 | 0% | $147 | Medium |
| White (Resin) Dental Filling - Two surfaces, posterior | $259 | 0% | $259 | Medium |
| White (Resin) Dental Filling - One surface, anterior | $131 | 0% | $131 | Medium |
| White (Resin) Dental Filling - Two surfaces, anterior | $158 | 0% | $158 | Medium |
Other Dental Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Tooth Extraction (Elevation and/or forceps removal) | $236 | 0% | $236 | Medium |