Merrimack Dental Associates
126a Pleasant Valley Street Methuen, MA 01844
Dental Procedures
Preventive Care
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Adult Dental Cleaning | $126 | 0% | $126 | 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 | $275 | 0% | $275 | Medium |
| Sealant placed on the tooth surface to prevent decay | $58 | 0% | $58 | Medium |
| Topical fluoride varnish application | $41 | 0% | $41 | Medium |
Diagnostic Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Comprehensive Dental Exam | $90 | 0% | $90 | Medium |
| Periodic dental exam - established patient | $54 | 0% | $54 | Medium |
| Problem focused evaluation limited to a specific oral health problem or complaint | $88 | 0% | $88 | Medium |
| X-Ray Dental - Complete intraoral series | $158 | 0% | $158 | Medium |
| X-Ray Dental - Four images - bitewings | $110 | 0% | $110 | Medium |
| X-Ray Dental - Intraoral - periapical radiographic image | $47 | 0% | $47 | Medium |
| X-Ray Dental - Two images - bitewings | $50 | 0% | $50 | Medium |
| X-Ray Dental - Additional image of tooth from crown to root, from inside mouth | $42 | 0% | $42 | Medium |
| X-Ray Dental - Whole mouth, from outside mouth | $158 | 0% | $158 | 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 | $233 | 0% | $233 | Medium |
| Silver (Amalgam) Dental Filling - Two surfaces, primary or permanent | $261 | 0% | $261 | Medium |
| Silver (Amalgam) Dental Filling - Three surfaces, primary or permanent | $340 | 0% | $340 | Medium |
| White (Resin) Dental Filling - One surface, posterior | $188 | 0% | $188 | Medium |
| White (Resin) Dental Filling - Two surfaces, posterior | $261 | 0% | $261 | Medium |
| White (Resin) Dental Filling - One surface, anterior | $164 | 0% | $164 | Medium |
| White (Resin) Dental Filling - Three surfaces, posterior | $340 | 0% | $340 | Medium |
| White (Resin) Dental Filling - Two surfaces, anterior | $217 | 0% | $217 | Medium |
Other Dental Services
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Maintenance Therapy - Periodontal | $163 | 0% | $163 | Medium |
| Tooth Extraction (Elevation and/or forceps removal) | $196 | 0% | $196 | Medium |