Kindred Smiles Pediatric Dentistry
Dental Procedures
| Procedure | Estimate of Total Cost | Number of Visits | What You Will Pay Uninsured Discount: 0% |
|---|---|---|---|
| Dental Cleaning - Adult | $118 | N/A | $118 |
| Dental Cleaning - Child | $89 | N/A | $89 |
| Dental Exam - Comprehensive | $108 | N/A | $108 |
| Dental Exam - Periodic, Established Patient | $70 | N/A | $70 |
| Dental Filling - Silver (Amalgam): Two Surfaces, Primary or Permanent | $515 | N/A | $515 |
| Dental Filling - White (Resin): Two Surfaces, Posterior | $257 | N/A | $257 |
| Flouride - Topical Varnish Application | $57 | N/A | $57 |
| Problem Focused Evaluation - Limited to a Specific Oral Health Problem or Complaint | $100 | N/A | $100 |
| Sealant - Placed on Tooth Surface to Prevent Decay | $72 | N/A | $72 |
| Tooth Extraction - Elevation and/or Forceps Removal | $206 | N/A | $206 |
| X-Ray - Additional Image of Tooth from Crown to Root from Inside Mouth | $34 | N/A | $34 |
| X-Ray - Four Images, Bitewings | $88 | N/A | $88 |
| X-Ray - Intraoral, Periapical Radiographic Image | $46 | N/A | $46 |
| X-Ray - Two Images, Bitewings | $67 | N/A | $67 |