Keene Smiles Dental

69 Island Street, Suite G Keene, NH 03431
Dental Procedures
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ProcedureEstimate of Total Cost Uninsured Discount What You Will Pay
Dental Cleaning - Adult$1100%$110
Dental Cleaning - Child$810%$81
Dental Exam - Comprehensive$1020%$102
Dental Exam - Periodic, Established Patient$640%$64
Dental Filling - Silver (Amalgam): One Surface, Primary or Permanent$2020%$202
Dental Filling - Silver (Amalgam): Three Surfaces, Primary or Permanent$3400%$340
Dental Filling - Silver (Amalgam): Two Surfaces, Primary or Permanent$2610%$261
Dental Filling - White (Resin): One Surface, Anterior$1870%$187
Dental Filling - White (Resin): One Surface, Posterior$2020%$202
Dental Filling - White (Resin): Three Surfaces, Posterior$3400%$340
Dental Filling - White (Resin): Two Surfaces, Anterior$2290%$229
Dental Filling - White (Resin): Two Surfaces, Posterior$2610%$261
Flouride - Topical Varnish Application$490%$49
Fluoride - Topical Application$430%$43
Maintenance Therapy - Periodontal$1510%$151
Orthodontic Treatment - Periodic Visit, Part of a Contract$910%$91
Plaque and Tartar Removal - Around Teeth and Gums, Per Quadrant$2850%$285
Problem Focused Evaluation - Limited to a Specific Oral Health Problem or Complaint$890%$89
Root Canal - Anterior Tooth$9190%$919
Root Canal - Bicuspid Tooth$1,0240%$1,024
Root Canal - Molar$1,2310%$1,231
Sealant - Placed on Tooth Surface to Prevent Decay$630%$63
Tooth Extraction - Elevation and/or Forceps Removal$1550%$155
X-Ray - Complete Intraoral Series$1530%$153
X-Ray - Four Images, Bitewings$750%$75
X-Ray - Intraoral, Periapical Radiographic Image$350%$35
X-Ray - Two Images, Bitewings$500%$50
X-Ray - Whole Mouth from Outside Mouth$1320%$132