Michael Francis Yannetti, DMD
150 Bridge Street Pelham, NH 03076
Dental Procedures
Preventive Care
| Procedure | Estimate of Total Cost | Uninsured Discount | What you Will Pay | Typical Patient Complexity |
|---|---|---|---|---|
| Adult Dental Cleaning | $104 | 0% | $104 | Medium |
| Child Dental Cleaning | $120 | 0% | $120 | Medium |
| Fluoride - Topical Application | $69 | 0% | $69 | Medium |
| Plaque and tartar removal from around teeth and gums-per quadrant | $278 | 0% | $278 | Medium |
| Sealant placed on the tooth surface to prevent decay | $80 | 0% | $80 | 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 | $55 | 0% | $55 | Medium |
| Problem focused evaluation limited to a specific oral health problem or complaint | $113 | 0% | $113 | Medium |
| X-Ray Dental - Complete intraoral series | $183 | 0% | $183 | Medium |
| X-Ray Dental - Four images - bitewings | $95 | 0% | $95 | Medium |
| X-Ray Dental - Intraoral - periapical radiographic image | $35 | 0% | $35 | Medium |
| X-Ray Dental - Two images - bitewings | $58 | 0% | $58 | Medium |
| X-Ray Dental - Additional image of tooth from crown to root, from inside mouth | $29 | 0% | $29 | Medium |
| X-Ray Dental - Whole mouth, from outside mouth | $129 | 0% | $129 | 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 | $235 | 0% | $235 | Medium |
| Silver (Amalgam) Dental Filling - Three surfaces, primary or permanent | $326 | 0% | $326 | Medium |
| White (Resin) Dental Filling - One surface, posterior | $194 | 0% | $194 | Medium |
| White (Resin) Dental Filling - Two surfaces, posterior | $244 | 0% | $244 | Medium |
| White (Resin) Dental Filling - One surface, anterior | $182 | 0% | $182 | Medium |
| White (Resin) Dental Filling - Three surfaces, posterior | $352 | 0% | $352 | 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 | $212 | 0% | $212 | Medium |
| Tooth Extraction (Elevation and/or forceps removal) | $214 | 0% | $214 | Medium |