Lancaster Dental Care
22 Bunker Hill Street Lancaster, NH 03584
Dental Procedures
Preventive Care
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Adult Dental Cleaning | $88 | 0% | $88 | Medium |
| Child Dental Cleaning | $71 | 0% | $71 | Medium |
| Fluoride - Topical Application | $40 | 0% | $40 | Medium |
| Plaque and tartar removal from around teeth and gums-per quadrant | $217 | 0% | $217 | Medium |
| Sealant placed on the tooth surface to prevent decay | $58 | 0% | $58 | Medium |
| Topical fluoride varnish application | $40 | 0% | $40 | Medium |
Diagnostic Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Comprehensive Dental Exam | $92 | 0% | $92 | Medium |
| Problem focused evaluation limited to a specific oral health problem or complaint | $82 | 0% | $82 | Medium |
| X-Ray Dental - Complete intraoral series | $228 | 0% | $228 | Medium |
| X-Ray Dental - Four images - bitewings | $66 | 0% | $66 | Medium |
| X-Ray Dental - Intraoral - periapical radiographic image | $26 | 0% | $26 | Medium |
| X-Ray Dental - Two images - bitewings | $48 | 0% | $48 | Medium |
| X-Ray Dental - Additional image of tooth from crown to root, from inside mouth | $23 | 0% | $23 | Medium |
| X-Ray Dental - Whole mouth, from outside mouth | $121 | 0% | $121 | 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 | $184 | 0% | $184 | Medium |
| Silver (Amalgam) Dental Filling - Two surfaces, primary or permanent | $173 | 0% | $173 | Medium |
| Silver (Amalgam) Dental Filling - Three surfaces, primary or permanent | $210 | 0% | $210 | Medium |
| White (Resin) Dental Filling - One surface, posterior | $184 | 0% | $184 | Medium |
| White (Resin) Dental Filling - Two surfaces, posterior | $227 | 0% | $227 | Medium |
| White (Resin) Dental Filling - One surface, anterior | $158 | 0% | $158 | Medium |
| White (Resin) Dental Filling - Three surfaces, posterior | $294 | 0% | $294 | Medium |
| White (Resin) Dental Filling - Two surfaces, anterior | $198 | 0% | $198 | 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) | $173 | 0% | $173 | Medium |