Mill Plaza Dental Associates
14 Bishop Road Belmont, NH 03220
Dental Procedures
| Procedure | Estimate of Total Cost | Uninsured Discount | What You Will Pay |
|---|---|---|---|
| Dental Cleaning - Adult | $122 | 0% | $122 |
| Dental Exam - Periodic, Established Patient | $118 | 0% | $118 |
| Dental Filling - Silver (Amalgam): Three Surfaces, Primary or Permanent | $460 | 0% | $460 |
| Dental Filling - White (Resin): Three Surfaces, Posterior | $460 | 0% | $460 |
| Flouride - Topical Varnish Application | $70 | 0% | $70 |
| Maintenance Therapy - Periodontal | $302 | 0% | $302 |
| X-Ray - Additional Image of Tooth from Crown to Root from Inside Mouth | $49 | 0% | $49 |
| X-Ray - Complete Intraoral Series | $161 | 0% | $161 |
| X-Ray - Four Images, Bitewings | $91 | 0% | $91 |
| X-Ray - Intraoral, Periapical Radiographic Image | $49 | 0% | $49 |