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 |
|---|---|---|---|---|
| Child Dental Cleaning | $120 | 0% | $120 | Medium |
| Fluoride - Topical Application | $56 | 0% | $56 | 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 | $89 | 0% | $89 | Medium |
| Periodic dental exam - established patient | $74 | 0% | $74 | Medium |
| Problem focused evaluation limited to a specific oral health problem or complaint | $113 | 0% | $113 | Medium |
| X-Ray Dental - Complete intraoral series | $145 | 0% | $145 | Medium |
| X-Ray Dental - Four images - bitewings | $74 | 0% | $74 | Medium |
| X-Ray Dental - Intraoral - periapical radiographic image | $34 | 0% | $34 | Medium |
| X-Ray Dental - Two images - bitewings | $57 | 0% | $57 | 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 | $128 | 0% | $128 | 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 | $188 | 0% | $188 | Medium |
| Silver (Amalgam) Dental Filling - Two surfaces, primary or permanent | $183 | 0% | $183 | Medium |
| Silver (Amalgam) Dental Filling - Three surfaces, primary or permanent | $223 | 0% | $223 | Medium |
| White (Resin) Dental Filling - One surface, posterior | $233 | 0% | $233 | Medium |
| White (Resin) Dental Filling - Two surfaces, posterior | $281 | 0% | $281 | Medium |
| White (Resin) Dental Filling - One surface, anterior | $180 | 0% | $180 | Medium |
| White (Resin) Dental Filling - Three surfaces, posterior | $391 | 0% | $391 | Medium |
| White (Resin) Dental Filling - Two surfaces, anterior | $236 | 0% | $236 | 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) | $260 | 0% | $260 | Medium |