Levesque Family Dentistry

193 Kinsley Street Nashua, NH 03064
Dental Procedures
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ProcedureEstimate of Total Cost Uninsured Discount What You Will Pay Typical Patient Complexity
Dental Cleaning - Adult$1260%$126 Medium
Dental Cleaning - Child$990%$99 Medium
Dental Exam - Comprehensive$1440%$144 Medium
Dental Exam - Periodic, Established Patient$600%$60 Medium
Dental Filling - Silver (Amalgam): One Surface, Primary or Permanent$2660%$266 Medium
Dental Filling - Silver (Amalgam): Three Surfaces, Primary or Permanent$4130%$413 Medium
Dental Filling - Silver (Amalgam): Two Surfaces, Primary or Permanent$3380%$338 Medium
Dental Filling - White (Resin): One Surface, Anterior$2470%$247 Medium
Dental Filling - White (Resin): One Surface, Posterior$2660%$266 Medium
Dental Filling - White (Resin): Three Surfaces, Posterior$4130%$413 Medium
Dental Filling - White (Resin): Two Surfaces, Anterior$3000%$300 Medium
Dental Filling - White (Resin): Two Surfaces, Posterior$3380%$338 Medium
Flouride - Topical Varnish Application$560%$56 Medium
Fluoride - Topical Application$560%$56 Medium
Maintenance Therapy - Periodontal$1760%$176 Medium
Plaque and Tartar Removal - Around Teeth and Gums, Per Quadrant$3570%$357 Medium
Problem Focused Evaluation - Limited to a Specific Oral Health Problem or Complaint$1170%$117 Medium
Root Canal - Bicuspid Tooth$9790%$979 Medium
Sealant - Placed on Tooth Surface to Prevent Decay$740%$74 Medium
Tooth Extraction - Elevation and/or Forceps Removal$2380%$238 Medium
X-Ray - Additional Image of Tooth from Crown to Root from Inside Mouth$360%$36 Medium
X-Ray - Complete Intraoral Series$2810%$281 Medium
X-Ray - Four Images, Bitewings$980%$98 Medium
X-Ray - Intraoral, Periapical Radiographic Image$460%$46 Medium
X-Ray - Two Images, Bitewings$690%$69 Medium
X-Ray - Whole Mouth from Outside Mouth$1840%$184 Medium