Maryam Mandsaurwala, DDS
7 Pleasant Street Malden, MA 02148
Dental Procedures
Preventive Care
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Adult Dental Cleaning | $110 | 0% | $110 | Medium |
| Child Dental Cleaning | $92 | 0% | $92 | Medium |
| Fluoride - Topical Application | $59 | 0% | $59 | Medium |
| Plaque and tartar removal from around teeth and gums-per quadrant | $293 | 0% | $293 | Medium |
| Sealant placed on the tooth surface to prevent decay | $60 | 0% | $60 | Medium |
| Topical fluoride varnish application | $59 | 0% | $59 | Medium |
Diagnostic Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Comprehensive Dental Exam | $89 | 0% | $89 | Medium |
| Periodic dental exam - established patient | $54 | 0% | $54 | Medium |
| Problem focused evaluation limited to a specific oral health problem or complaint | $89 | 0% | $89 | Medium |
| X-Ray Dental - Complete intraoral series | $146 | 0% | $146 | Medium |
| X-Ray Dental - Four images - bitewings | $74 | 0% | $74 | Medium |
| X-Ray Dental - Intraoral - periapical radiographic image | $40 | 0% | $40 | Medium |
| X-Ray Dental - Two images - bitewings | $53 | 0% | $53 | Medium |
| X-Ray Dental - Additional image of tooth from crown to root, from inside mouth | $32 | 0% | $32 | Medium |
| X-Ray Dental - Whole mouth, from outside mouth | $132 | 0% | $132 | 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 | $208 | 0% | $208 | Medium |
| Silver (Amalgam) Dental Filling - Two surfaces, primary or permanent | $264 | 0% | $264 | Medium |
| Silver (Amalgam) Dental Filling - Three surfaces, primary or permanent | $284 | 0% | $284 | Medium |
| White (Resin) Dental Filling - One surface, posterior | $208 | 0% | $208 | Medium |
| White (Resin) Dental Filling - Two surfaces, posterior | $264 | 0% | $264 | Medium |
| White (Resin) Dental Filling - One surface, anterior | $166 | 0% | $166 | Medium |
| White (Resin) Dental Filling - Three surfaces, posterior | $344 | 0% | $344 | Medium |
| White (Resin) Dental Filling - Two surfaces, anterior | $271 | 0% | $271 | Medium |
Other Dental Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Maintenance Therapy - Periodontal | $150 | 0% | $150 | Medium |
| Tooth Extraction (Elevation and/or forceps removal) | $229 | 0% | $229 | Medium |