Margaret Figueroa-Supplies, DMD
290 Littleton Road, #5 Chelmsford, MA 01824
Dental Procedures
Preventive Care
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Adult Dental Cleaning | $100 | 0% | $100 | Medium |
| Child Dental Cleaning | $118 | 0% | $118 | Medium |
| Topical fluoride varnish application | $92 | 0% | $92 | Medium |
Diagnostic Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Comprehensive Dental Exam | $91 | 0% | $91 | Medium |
| Periodic dental exam - established patient | $57 | 0% | $57 | Medium |
| X-Ray Dental - Complete intraoral series | $147 | 0% | $147 | Medium |
| X-Ray Dental - Four images - bitewings | $74 | 0% | $74 | Medium |
| X-Ray Dental - Intraoral - periapical radiographic image | $38 | 0% | $38 | Medium |
| X-Ray Dental - Two images - bitewings | $45 | 0% | $45 | Medium |
| X-Ray Dental - Additional image of tooth from crown to root, from inside mouth | $17 | 0% | $17 | Medium |
| X-Ray Dental - Whole mouth, from outside mouth | $126 | 0% | $126 | 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 | $185 | 0% | $185 | Medium |
| Silver (Amalgam) Dental Filling - Two surfaces, primary or permanent | $227 | 0% | $227 | Medium |
| Silver (Amalgam) Dental Filling - Three surfaces, primary or permanent | $301 | 0% | $301 | Medium |
| White (Resin) Dental Filling - One surface, posterior | $145 | 0% | $145 | Medium |
| White (Resin) Dental Filling - Two surfaces, posterior | $246 | 0% | $246 | Medium |
| White (Resin) Dental Filling - Three surfaces, posterior | $301 | 0% | $301 | Medium |
| White (Resin) Dental Filling - Two surfaces, anterior | $176 | 0% | $176 | Medium |
Other Dental Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Maintenance Therapy - Periodontal | $193 | 0% | $193 | Medium |
| Tooth Extraction (Elevation and/or forceps removal) | $184 | 0% | $184 | Medium |