Dental Procedures
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ProcedureEstimate of Total Cost Number of Visits What You Will Pay Uninsured Discount: 0%
Dental Cleaning - Adult$111N/A$111
Dental Cleaning - Child$89N/A$89
Dental Exam - Comprehensive$99N/A$99
Dental Exam - Periodic, Established Patient$54N/A$54
Dental Filling - Silver (Amalgam): One Surface, Primary or Permanent$248N/A$248
Dental Filling - Silver (Amalgam): Three Surfaces, Primary or Permanent$390N/A$390
Dental Filling - Silver (Amalgam): Two Surfaces, Primary or Permanent$311N/A$311
Dental Filling - White (Resin): One Surface, Anterior$223N/A$223
Dental Filling - White (Resin): One Surface, Posterior$248N/A$248
Dental Filling - White (Resin): Three Surfaces, Posterior$390N/A$390
Dental Filling - White (Resin): Two Surfaces, Anterior$269N/A$269
Dental Filling - White (Resin): Two Surfaces, Posterior$311N/A$311
Flouride - Topical Varnish Application$53N/A$53
Maintenance Therapy - Periodontal$161N/A$161
Oral Hygiene Instructions$46N/A$46
Problem Focused Evaluation - Limited to a Specific Oral Health Problem or Complaint$97N/A$97
Root Canal - Anterior Tooth$983N/A$983
Root Canal - Molar$1,392N/A$1,392
Sealant - Placed on Tooth Surface to Prevent Decay$65N/A$65
Tooth Extraction - Elevation and/or Forceps Removal$221N/A$221
X-Ray - Additional Image of Tooth from Crown to Root from Inside Mouth$32N/A$32
X-Ray - Complete Intraoral Series$173N/A$173
X-Ray - Four Images, Bitewings$82N/A$82
X-Ray - Intraoral, Periapical Radiographic Image$42N/A$42
X-Ray - Two Images, Bitewings$60N/A$60