Dental Procedures
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ProcedureEstimate of Total Cost Uninsured Discount What You Will Pay Typical Patient Complexity
Dental Cleaning - Adult$1110%$111 Medium
Dental Cleaning - Child$890%$89 Medium
Dental Exam - Comprehensive$990%$99 Medium
Dental Exam - Periodic, Established Patient$540%$54 Medium
Dental Filling - Silver (Amalgam): One Surface, Primary or Permanent$2380%$238 Medium
Dental Filling - Silver (Amalgam): Three Surfaces, Primary or Permanent$3900%$390 Medium
Dental Filling - Silver (Amalgam): Two Surfaces, Primary or Permanent$3050%$305 Medium
Dental Filling - White (Resin): One Surface, Anterior$2230%$223 Medium
Dental Filling - White (Resin): One Surface, Posterior$2480%$248 Medium
Dental Filling - White (Resin): Three Surfaces, Posterior$3900%$390 Medium
Dental Filling - White (Resin): Two Surfaces, Anterior$2690%$269 Medium
Dental Filling - White (Resin): Two Surfaces, Posterior$3110%$311 Medium
Flouride - Topical Varnish Application$530%$53 Medium
Fluoride - Topical Application$530%$53 Medium
Maintenance Therapy - Periodontal$1610%$161 Medium
Plaque and Tartar Removal - Around Teeth and Gums, Per Quadrant$3030%$303 Medium
Problem Focused Evaluation - Limited to a Specific Oral Health Problem or Complaint$970%$97 Medium
Root Canal - Anterior Tooth$9830%$983 Medium
Root Canal - Molar$1,3390%$1,339 Medium
Sealant - Placed on Tooth Surface to Prevent Decay$630%$63 Medium
Tooth Extraction - Elevation and/or Forceps Removal$2120%$212 Medium
X-Ray - Additional Image of Tooth from Crown to Root from Inside Mouth$320%$32 Medium
X-Ray - Complete Intraoral Series$1730%$173 Medium
X-Ray - Four Images, Bitewings$820%$82 Medium
X-Ray - Intraoral, Periapical Radiographic Image$420%$42 Medium
X-Ray - Two Images, Bitewings$600%$60 Medium