Leslie Ann Elston
Dental Procedures
| Procedure | Estimate of Total Cost | Uninsured Discount | What You Will Pay |
|---|---|---|---|
| Dental Cleaning - Adult | $95 | 0% | $95 |
| Dental Exam - Periodic, Established Patient | $42 | 0% | $42 |
| Dental Filling - White (Resin): One Surface, Posterior | $181 | 0% | $181 |
| Flouride - Topical Varnish Application | $34 | 0% | $34 |
| Problem Focused Evaluation - Limited to a Specific Oral Health Problem or Complaint | $71 | 0% | $71 |
| X-Ray - Complete Intraoral Series | $197 | 0% | $197 |
| X-Ray - Intraoral, Periapical Radiographic Image | $30 | 0% | $30 |