Manchester Smiles Youth Dentistry

8 Vinton Street Manchester, NH 03103
Dental Procedures
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My Health Insurance:

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ProcedureEstimate of Total Cost Uninsured Discount What You Will Pay
Dental Cleaning - Adult$1550%$155
Dental Cleaning - Child$1200%$120
Dental Exam - Comprehensive$1200%$120
Dental Exam - Periodic, Established Patient$740%$74
Dental Filling - Silver (Amalgam): One Surface, Primary or Permanent$2080%$208
Dental Filling - Silver (Amalgam): Three Surfaces, Primary or Permanent$3610%$361
Dental Filling - Silver (Amalgam): Two Surfaces, Primary or Permanent$3030%$303
Dental Filling - White (Resin): One Surface, Anterior$1960%$196
Dental Filling - White (Resin): One Surface, Posterior$2320%$232
Dental Filling - White (Resin): Three Surfaces, Posterior$4600%$460
Dental Filling - White (Resin): Two Surfaces, Anterior$2990%$299
Dental Filling - White (Resin): Two Surfaces, Posterior$3210%$321
Flouride - Topical Varnish Application$560%$56
Fluoride - Topical Application$690%$69
Maintenance Therapy - Periodontal$1930%$193
Plaque and Tartar Removal - Around Teeth and Gums, Per Quadrant$3200%$320
Problem Focused Evaluation - Limited to a Specific Oral Health Problem or Complaint$1080%$108
Sealant - Placed on Tooth Surface to Prevent Decay$890%$89
Tooth Extraction - Elevation and/or Forceps Removal$2730%$273
X-Ray - Additional Image of Tooth from Crown to Root from Inside Mouth$340%$34
X-Ray - Complete Intraoral Series$2180%$218
X-Ray - Four Images, Bitewings$1200%$120
X-Ray - Intraoral, Periapical Radiographic Image$530%$53
X-Ray - Two Images, Bitewings$760%$76
X-Ray - Whole Mouth from Outside Mouth$1640%$164